173例转移性非透明细胞肾细胞癌(nccRCC)的真实预后:泌尿生殖系统肿瘤中心组的经验

IF 1.1 Q4 ONCOLOGY Kidney Cancer Pub Date : 2019-01-01 DOI:10.3233/KCA-180045
A. Martín, J. Puente, Á. Pinto, P. Gajate, T. A. Gordoa, E. Grande, A. Herrero, C. Maximiano, M. Garrido, I. Gallegos, Maria L. Villalobos, J. García-Donas, E. Caviedes, I. García, J. Espinosa, C. Aguado, J. Arranz, L. García, J. F. Rodriguez, J. Casinello, L. Rodríguez
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引用次数: 2

摘要

非透明细胞肾细胞癌(nccRCC)代表了一组多种组织学亚型,具有不同的临床结果和不确定的最佳治疗方法。在透明细胞肿瘤中收集的数据通常被推断为nccRCC,尽管其潜在的生物学特性不同。泌尿生殖系统肿瘤中心小组是一个由马德里和周边省份医院的医学肿瘤学家组成的网络,他们专注于泌尿生殖系统肿瘤。对1995年至2015年间在中心集团医院诊断和治疗的nccRCC患者的预后进行了一项回顾性、多中心研究。分析患者的基线临床特征、组织学亚型、治疗管理和生存状况。数据来自173例患者,诊断时中位年龄65岁[24-90],67.1%为男性。组织学亚型包括55.5%乳头状癌、23.1%肉瘤样癌、13.9%憎色瘤、6.9%未分类肿瘤和0.6%嗜瘤细胞瘤。159例患者接受一线治疗,包括酪氨酸激酶抑制剂(67.9%)和哺乳动物雷帕霉素靶点抑制剂(11.9%)。142例可评估患者的缓解率(RR)为:完全缓解5.6%,部分缓解17.6%,病情稳定40.8%,病情进展35.9%。90例(52.0%)患者接受了二线治疗。截至数据截止点(2016年4月1日),126例患者死亡,中位总生存期(OS)为17.9个月[95% CI 15.0-20.9]。本研究报告的临床结果与其他已发表的研究具有相似的OS。然而,在不同的亚型之间存在着实质性的差异。总体而言,nccRCC的预后仍然很差。在作为一线或二线治疗的全身药物的活性方面没有观察到显著差异。
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Real-World Outcome of 173 Metastatic Non-Clear Cell Renal Cell Carcinoma (nccRCC) Cases: The Experience of the Center Group for Genitourinary Tumors
Non-clear cell renal cell carcinoma (nccRCC) represents a group of multiple histologic subtypes, with different clinical outcomes and an uncertain optimal treatment. Data collected in clear cell tumors are routinely extrapolated to nccRCC, despite a different underlying biology. The Center Group for Genitourinary tumors is a network of medical oncologists from hospitals in Madrid and surrounding provinces that are focused on genitourinary tumors. A retrospective, multicenter study of the outcome of patients with nccRCC diagnosed and treated at the Center Group hospitals between 1995 and 2015 was performed. Baseline clinical features, histologic subtypes, therapeutic management and survival status were analyzed. Data was collected from 173 patients, with a median age at diagnosis of 65 years [24–90], 67.1% were male. Histologic subtypes comprised 55.5% papillary carcinoma, 23.1% sarcomatoid, 13.9% chromophobe, 6.9% unclassified tumors and 0.6% oncocytoma. 159 patients received first line therapy including tyrosine kinase inhibitors (67.9%) and mammalian target of rapamycin inhibitors (11.9%). The response rates (RR) in evaluable patients (142) were: complete response 5.6%, partial response 17.6%, stable disease 40.8% and progression in 35.9% of cases. 90 patients (52.0%) received second line treatment. At the time of the data cut-off point (April 1, 2016), 126 patients had died, with a median overall survival (OS) of 17.9 months [95% CI 15.0–20.9]. The clinical outcome reported in this study has a similar OS to other published studies. Nevertheless, there are substantial differences among the distinct subtypes. Overall, prognosis in nccRCC remains poor. No significant differences were observed in the activity of systemic agents, used as either first or second line therapy.
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来源期刊
Kidney Cancer
Kidney Cancer Multiple-
CiteScore
0.90
自引率
8.30%
发文量
23
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