Effect of number and location of distant metastases on renal cell carcinoma mortality in candidates for cytoreductive nephrectomy: Implications for multimodal therapy

Umberto Capitanio, Firas Abdollah, Rayan Matloob, Andrea Salonia, Nazareno Suardi, Alberto Briganti, Cristina Carenzi, Patrizio Rigatti, Francesco Montorsi, Roberto Bertini

Research output: Contribution to journalArticle

Abstract

Objective: To test whether the combination of number and location of distant metastases affects cancer-specific survival in patients with metastatic renal cell carcinoma. Methods: Overall, 242 metastatic renal cell carcinoma patients with synchronous metastases at diagnosis underwent cytoreductive nephrectomy at a single institution. Combinations of number and location of distant metastases were coded as: single metastasis and single organ affected, multiple metastases and single organ affected, single metastasis for each of the multiple organs affected, and multiple metastases for each of the multiple organs affected. Covariates included age, symptoms, performance status, American Society of Anesthesiologists score, hemoglobin, lactate dehydrogenase, tumor size, Fuhrman grade, T stage, lymph node status, necrosis, sarcomatoid features and metastasectomy at the time of nephrectomy. Results: The median survival was 34.7 versus 32.3 versus 29.6 versus 8.5months for single metastasis and single organ affected, multiple metastases and single organ affected single metastasis for each of the multiple organs affected, and multiple metastases for each of the multiple organs affected patients, respectively. At multivariable analyses, the combination of number and location of distant metastases resulted in one of the most informative and independent predictors of cancer-specific survival in metastatic renal cell carcinoma patients. The lung was the location with the highest rate of single organ affected (50.3% vs 35.1% in other sites; P0.3) among different metastatic organs. Conclusions: Among metastatic renal cell carcinoma patients undergoing cytoreductive nephrectomy, the combination of the number and location of distant metastases is a major independent predictor of cancer-specific survival. Patients with multiple organs affected by multifocal disease are more likely to have poorer survival.

Original languageEnglish
Pages (from-to)572-579
Number of pages8
JournalInternational Journal of Urology
Volume20
Issue number6
DOIs
Publication statusPublished - Jun 2013

Keywords

  • Cancer-specific survival
  • Cytoreductive surgery
  • Metastases
  • Nephrectomy
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Urology

Fingerprint Dive into the research topics of 'Effect of number and location of distant metastases on renal cell carcinoma mortality in candidates for cytoreductive nephrectomy: Implications for multimodal therapy'. Together they form a unique fingerprint.

  • Cite this