6533b7d2fe1ef96bd125f787

RESEARCH PRODUCT

Bone metastases in patients with metastatic renal cell carcinoma: are they always associated with poor prognosis?

Alfredo BerrutiDelia De LisiGaetano LanzettaVincenzo AdamoGiacomo CartenìCinzia OrtegaMaria Antonietta SatolliRoberto SabbatiniRodolfo MontironiStefano CascinuGiuseppe BadalamentiStefano Luzi FedeliRossana BerardiBruno VincenziNicola SilvestrisGiuseppe ToniniAlessandro ContiPorta CamilloDaniele SantiniMatteo SantoniEvaristo MaielloFrancesca Maria TancaDavide OttavianiSaverio CinieriAlessandra FeliciGiuseppe ProcopioSergio BracardaAntonio RussoAndrea FontanaElena CollovàToni IbrahimFrancesco Maria GuidaFrancesco MassariSandro Barni

subject

OncologyAdultMalemedicine.medical_specialtyCancer ResearchPrognosimedicine.medical_treatmentBone NeoplasmsBone NeoplasmPrognostic factorsMetastasisRenal cell carcinomaRetrospective StudieBone metastasis; Prognostic factors; Renal cell carcinoma; Time to distant metastasis; Cancer Research; OncologyInternal medicineBone metastasis Prognostic factors Renal cell carcinoma Time to distant metastasisCarcinomaMedicineHumansLymph nodeCarcinoma Renal CellSurvival analysisAgedRetrospective StudiesBone metastasis; Prognostic factors; Renal cell carcinoma; Time to distant metastasis; Adult; Aged; Aged 80 and over; Bone Neoplasms; Carcinoma Renal Cell; Female; Humans; Kidney Neoplasms; Male; Middle Aged; Prognosis; Retrospective Studies; Survival Analysis; Cancer Research; OncologyAged 80 and overPrognostic factorTime to distant metastasibusiness.industryResearchTime to distant metastasisBone metastasisKidney NeoplasmBone metastasisMiddle Agedmedicine.diseasePrognosisSurvival AnalysisNephrectomyRenal cell carcinomaKidney Neoplasmsmedicine.anatomical_structureOncologyConcomitantBone metastasiFemaleSurvival AnalysibusinessHuman

description

Purpose: Aim of this study was to investigate for the presence of existing prognostic factors in patients with bone metastases (BMs) from RCC since bone represents an unfavorable site of metastasis for renal cell carcinoma (mRCC). Materials and methods: Data of patients with BMs from RCC were retrospectively collected. Age, sex, ECOG-Performance Status (PS), MSKCC group, tumor histology, presence of concomitant metastases to other sites, time from nephrectomy to bone metastases (TTBM, classified into three groups: <1 year, between 1 and 5 years and >5 years) and time from BMs to skeletal-related event (SRE) were included in the Cox analysis to investigate their prognostic relevance. Results: 470 patients were enrolled in this analysis. In 19 patients (4%),bone was the only metastatic site; 277 patients had concomitant metastases in other sites. Median time to BMs was 16 months (range 0 - 44y) with Median OS of 17 months. Number of metastatic sites (including bone, p = 0.01), concomitant metastases, high Fuhrman grade (p < 0.001) and non-clear cell histology (p = 0.013) were significantly associated with poor prognosis. Patients with TTBM >5 years had longer OS (22 months) compared to patients with TTBM <1 year (13 months) or between 1 and 5 years (19 months) from nephrectomy (p < 0.001), no difference was found between these two last groups (p = 0.18). At multivariate analysis, ECOG-PS, MSKCC group and concomitant lung or lymph node metastases were independent predictors of OS in patients with BMs. Conclusions: Our study suggest that age, ECOG-PS, histology, MSKCC score, TTBM and the presence of concomitant metastases should be considered in order to optimize the management of RCC patients with BMs.

10.1186/s13046-015-0122-0http://dx.doi.org/10.1186/s13046-015-0122-0