Prognostic factors in de novo metastatic renal cell carcinoma: A report from the latin american renal cancer group

Abreu D.; Carvalhal G.; Gueglio G.; Tobia I.; Garcia P.; Zuñiga A.; Meza L.; Bengio R.; Scorticati C.; Castillejos R.; Rodriguez F.; Autran A.M.; Gonzales C.; Gadu J.; Nolazco A.; Ameri C.; Zampolli H.; Langenhin R.; Muguruza D.; Machado M.T.; Mingote P.; Yandian J.; Clavijo J.; Nogueira L.; Clark O.; Secin F.; Rovegno A.; Vilas A.; Barrios E.; Decia R.; Guimarães G.; Glina S.; Pal S.K.; Rodriguez O.; Palou J.; Spiess P.; Lara P.N., Jr; Marston Linehan W.; Pastore A.L.; Zequi S.C. · JCO Global Oncology (2021) · DOI: 10.1200/go.20.00621

Resumen

PURPOSE To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries. PATIENTS AND METHODS Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method. RESULTS Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58). CONCLUSION Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.