Is It Possible to Improve Prognostic Classification in Patients Affected by Metastatic Renal Cell Carcinoma With an Intermediate or Poor Prognosis?

Roberto Iacovelli, Ugo De Giorgi, Luca Galli, Paolo Zucali, Franco Nolè, Roberto Sabbatini, Anna Paola Fraccon, Umberto Basso, Alessandra Mosca, Francesco Atzori, Daniele Santini, Gaetano Facchini, Giuseppe Fornarini, Felice Pasini, Cristina Masini, Francesco Massari, Sebastiano Buti, Teodoro Sava, Cosimo Sacco, Riccardo RicottaIsabella Sperduti, Giampaolo Tortora, Camillo Porta

Research output: Contribution to journalArticle

Abstract

We analyzed the prognosis of patients affected by metastatic renal cell carcinoma (mRCC) with an intermediate or a poor prognosis using the International mRCC Database Consortium criteria and treated with first-line sunitinib. We found that within the intermediate class, as well as within the poor prognosis group, the expected survival will be significantly different according to the presence of 1 or 2 prognostic factors. Background: The International mRCC (metastatic renal cell carcinoma) Database Consortium (IMDC) is the standard classification for mRCC. We aimed to evaluate the outcomes of a large cohort of patients with an intermediate or a poor prognosis treated with sunitinib using a different cutoff point for IMDC to improve the classification. Patients and Methods: Patients with an intermediate or a poor prognosis according to the IMDC criteria and treated with sunitinib were included in the present study. A new cutoff point was used to categorize the patients. The new score was validated in an independent cohort of patients. Results: A total of 457 patients were included in the present study. Significant differences in overall survival (OS) were highlighted regarding the number of prognostic factors. Three categories were identified according to the presence of 1 (ie, favorable-intermediate group), 2 (ie, real-intermediate group), and > 2 (ie, poor group) factors. The corresponding median OS periods were 32.9, 20.0, and 8.9 months, with significant differences among the groups. The validation cohort included 389 patients. The median OS period for the favorable-intermediate group, real-intermediate group, and poor group was 34.3, 19.4, and 9.0 months, respectively, with confirmed significant differences among the groups. Conclusion: Our analysis revealed significant differences among patients with an intermediate prognosis using the IMDC prognostic factors. Further investigations to optimize the use of available and upcoming therapies are required.
Original languageEnglish
Pages (from-to)355-359.e1
JournalClinical Genitourinary Cancer
Volume16
Issue number5
DOIs
Publication statusPublished - Oct 1 2018

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Renal Cell Carcinoma
Databases
Survival

Keywords

  • Intermediate risk
  • mRCC
  • Overall survival
  • Poor risk
  • Sunitinib

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Is It Possible to Improve Prognostic Classification in Patients Affected by Metastatic Renal Cell Carcinoma With an Intermediate or Poor Prognosis? / Iacovelli, Roberto; De Giorgi, Ugo; Galli, Luca; Zucali, Paolo; Nolè, Franco; Sabbatini, Roberto; Fraccon, Anna Paola; Basso, Umberto; Mosca, Alessandra; Atzori, Francesco; Santini, Daniele; Facchini, Gaetano; Fornarini, Giuseppe; Pasini, Felice; Masini, Cristina; Massari, Francesco; Buti, Sebastiano; Sava, Teodoro; Sacco, Cosimo; Ricotta, Riccardo; Sperduti, Isabella; Tortora, Giampaolo; Porta, Camillo.

In: Clinical Genitourinary Cancer, Vol. 16, No. 5, 01.10.2018, p. 355-359.e1.

Research output: Contribution to journalArticle

Iacovelli, R, De Giorgi, U, Galli, L, Zucali, P, Nolè, F, Sabbatini, R, Fraccon, AP, Basso, U, Mosca, A, Atzori, F, Santini, D, Facchini, G, Fornarini, G, Pasini, F, Masini, C, Massari, F, Buti, S, Sava, T, Sacco, C, Ricotta, R, Sperduti, I, Tortora, G & Porta, C 2018, 'Is It Possible to Improve Prognostic Classification in Patients Affected by Metastatic Renal Cell Carcinoma With an Intermediate or Poor Prognosis?', Clinical Genitourinary Cancer, vol. 16, no. 5, pp. 355-359.e1. https://doi.org/10.1016/j.clgc.2018.04.007
Iacovelli, Roberto ; De Giorgi, Ugo ; Galli, Luca ; Zucali, Paolo ; Nolè, Franco ; Sabbatini, Roberto ; Fraccon, Anna Paola ; Basso, Umberto ; Mosca, Alessandra ; Atzori, Francesco ; Santini, Daniele ; Facchini, Gaetano ; Fornarini, Giuseppe ; Pasini, Felice ; Masini, Cristina ; Massari, Francesco ; Buti, Sebastiano ; Sava, Teodoro ; Sacco, Cosimo ; Ricotta, Riccardo ; Sperduti, Isabella ; Tortora, Giampaolo ; Porta, Camillo. / Is It Possible to Improve Prognostic Classification in Patients Affected by Metastatic Renal Cell Carcinoma With an Intermediate or Poor Prognosis?. In: Clinical Genitourinary Cancer. 2018 ; Vol. 16, No. 5. pp. 355-359.e1.
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T1 - Is It Possible to Improve Prognostic Classification in Patients Affected by Metastatic Renal Cell Carcinoma With an Intermediate or Poor Prognosis?

AU - Iacovelli, Roberto

AU - De Giorgi, Ugo

AU - Galli, Luca

AU - Zucali, Paolo

AU - Nolè, Franco

AU - Sabbatini, Roberto

AU - Fraccon, Anna Paola

AU - Basso, Umberto

AU - Mosca, Alessandra

AU - Atzori, Francesco

AU - Santini, Daniele

AU - Facchini, Gaetano

AU - Fornarini, Giuseppe

AU - Pasini, Felice

AU - Masini, Cristina

AU - Massari, Francesco

AU - Buti, Sebastiano

AU - Sava, Teodoro

AU - Sacco, Cosimo

AU - Ricotta, Riccardo

AU - Sperduti, Isabella

AU - Tortora, Giampaolo

AU - Porta, Camillo

PY - 2018/10/1

Y1 - 2018/10/1

N2 - We analyzed the prognosis of patients affected by metastatic renal cell carcinoma (mRCC) with an intermediate or a poor prognosis using the International mRCC Database Consortium criteria and treated with first-line sunitinib. We found that within the intermediate class, as well as within the poor prognosis group, the expected survival will be significantly different according to the presence of 1 or 2 prognostic factors. Background: The International mRCC (metastatic renal cell carcinoma) Database Consortium (IMDC) is the standard classification for mRCC. We aimed to evaluate the outcomes of a large cohort of patients with an intermediate or a poor prognosis treated with sunitinib using a different cutoff point for IMDC to improve the classification. Patients and Methods: Patients with an intermediate or a poor prognosis according to the IMDC criteria and treated with sunitinib were included in the present study. A new cutoff point was used to categorize the patients. The new score was validated in an independent cohort of patients. Results: A total of 457 patients were included in the present study. Significant differences in overall survival (OS) were highlighted regarding the number of prognostic factors. Three categories were identified according to the presence of 1 (ie, favorable-intermediate group), 2 (ie, real-intermediate group), and > 2 (ie, poor group) factors. The corresponding median OS periods were 32.9, 20.0, and 8.9 months, with significant differences among the groups. The validation cohort included 389 patients. The median OS period for the favorable-intermediate group, real-intermediate group, and poor group was 34.3, 19.4, and 9.0 months, respectively, with confirmed significant differences among the groups. Conclusion: Our analysis revealed significant differences among patients with an intermediate prognosis using the IMDC prognostic factors. Further investigations to optimize the use of available and upcoming therapies are required.

AB - We analyzed the prognosis of patients affected by metastatic renal cell carcinoma (mRCC) with an intermediate or a poor prognosis using the International mRCC Database Consortium criteria and treated with first-line sunitinib. We found that within the intermediate class, as well as within the poor prognosis group, the expected survival will be significantly different according to the presence of 1 or 2 prognostic factors. Background: The International mRCC (metastatic renal cell carcinoma) Database Consortium (IMDC) is the standard classification for mRCC. We aimed to evaluate the outcomes of a large cohort of patients with an intermediate or a poor prognosis treated with sunitinib using a different cutoff point for IMDC to improve the classification. Patients and Methods: Patients with an intermediate or a poor prognosis according to the IMDC criteria and treated with sunitinib were included in the present study. A new cutoff point was used to categorize the patients. The new score was validated in an independent cohort of patients. Results: A total of 457 patients were included in the present study. Significant differences in overall survival (OS) were highlighted regarding the number of prognostic factors. Three categories were identified according to the presence of 1 (ie, favorable-intermediate group), 2 (ie, real-intermediate group), and > 2 (ie, poor group) factors. The corresponding median OS periods were 32.9, 20.0, and 8.9 months, with significant differences among the groups. The validation cohort included 389 patients. The median OS period for the favorable-intermediate group, real-intermediate group, and poor group was 34.3, 19.4, and 9.0 months, respectively, with confirmed significant differences among the groups. Conclusion: Our analysis revealed significant differences among patients with an intermediate prognosis using the IMDC prognostic factors. Further investigations to optimize the use of available and upcoming therapies are required.

KW - Intermediate risk

KW - mRCC

KW - Overall survival

KW - Poor risk

KW - Sunitinib

U2 - 10.1016/j.clgc.2018.04.007

DO - 10.1016/j.clgc.2018.04.007

M3 - Article

VL - 16

SP - 355-359.e1

JO - Clinical Genitourinary Cancer

JF - Clinical Genitourinary Cancer

SN - 1558-7673

IS - 5

ER -