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Natural history of bone-only metastasis in renal cell carcinoma. | LitMetric

Natural history of bone-only metastasis in renal cell carcinoma.

Urol Oncol

Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Genitourinary Oncology, Peking University Cancer Hospital & Institute, Beijing, China. Electronic address:

Published: April 2024

AI Article Synopsis

  • Bone metastasis (BM) in renal cell carcinoma (RCC) is linked to a poor prognosis, but there's uncertainty on how to treat patients with only bone metastases.
  • A study at Peking University Cancer Hospital analyzed data from 54 RCC patients with bone-only metastases, revealing that many faced disease progression with a median progression-free survival (PFS) of 16.2 months and overall survival (OS) of 65.2 months.
  • Results indicated that patients with fewer metastatic sites had better outcomes, and factors like the number of metastasis sites and certain RCC characteristics can help predict survival and influence treatment options.

Article Abstract

Background: Bone metastasis (BM) is considered a poor prognostic factor of renal cell carcinoma (RCC). Confusion exists regarding how to deal with RCC patients with bone-only metastasis.

Patients And Methods: The clinical data of consecutive RCC patients with bone-only metastasis at Peking University Cancer Hospital between 2006 and 2018 were retrospectively collected and analyzed.

Results: Fifty-four eligible patients were screened from an RCC database of 1,878 metastatic patients. After a median follow-up of 43.6 m, 61.1% of the patients were presented with progression of prior BM or new BM. The progression-free survival (PFS) and overall survival (OS) was 16.2 m (95%CI: 11.4-21.0) and 65.2 m, respectively. For the 30 patients with oligo-metastasis (≤3 loci) and 24 ones with multiple-metastasis (>3 loci), the median OS was not reached and 42.0m (95%CI: 12.7-71.2) with statistical difference (P < 0.001). In the oligo-metastasis group, the median PFS of the 15 patients treated with local therapy and of the 13 patients treated with systemic therapy was 14.2 m (95%CI: 5.3-23.3) and 18.0 m (95%CI:15.4-20.6), respectively. In the multiple-metastasis group, the median PFS and OS of the 18 patients treated with systemic therapy was 16.6 m (95%CI: 7.5-25.7) and 63.9 m (95%CI: 21.8-106.0), respectively. Univariate analysis and multivariate analysis showed that the number of metastatic sites (oligo/multiple) and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) score, RCC pathological subtype were significantly associated with prognosis (P < 0.05).

Conclusion: RCC patients with bone-only metastases have a favorable prognosis. The number of metastatic sites, IMDC, RCC pathological subtype could serve as survival predictors, which might provide clue of treatment modality.

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Source
http://dx.doi.org/10.1016/j.urolonc.2024.01.030DOI Listing

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