Elvina Almuradova, Tugba Basoglu, Erdinc Nayir, Ertugrul Bayram, Semra Paydas, Ivo Gokmen, Serdar Karakaya, Berna Oksuzoglu, Dilek Erdem, Abdullah Sakin, Mustafa Atcı, Burcu Belen Gulbagcı, Ilhan Hacibekiroglu, Arif Hakan Onder, Serap Karaarslan, Melek Karakurt Eryılmaz, Mustafa Korkmaz, Ozan Yazıcı, Osman Sutcuoglu, Baran Akagunduz, Haci Arak, Teoman Sakalar, Dincer Aydin, Yakup Iriagac, Ozkan Alan, Murat Midik, Denis Cetin, Asli-Dilara Kip, Serdar Turhal, Turgut Kacan, Tolga Koseci
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The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. 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引用次数: 0
摘要
肉瘤样肾细胞癌(sRCC)是一种罕见的肾细胞癌(RCC),预后较差。我们回顾了土耳其肿瘤中心患者的预后。我们的目标是分享我们的现实生活经验,并为文学做出贡献。分析了148例sRCC患者的人口学、临床特征、治疗和生存结局。诊断时的中位年龄为58岁(范围:19-83岁)。大多数患者(62.8%)具有透明细胞组织学。大多数患者属于Memorial Sloan-Kettering Cancer Center (MSKCC)中间风险组(67.6%),诊断时为第4期(63.5%)。最常见的转移部位是肺(60.1%)、淋巴结(47.3%)和骨(35.8%)。患者接受了中位数为两条线(范围:0-6)的治疗。最常见的副作用是疲劳、血液学副作用、高血压和甲状腺功能减退。中位随访时间为20.9个月(1-162个月)。中位总生存期(OS)为30.8个月(95%可信区间:24.9-36.7个月)。在多因素分析中,MSKCC评分高、肉瘤样分化率>50%、4期、诊断时有肺转移是影响OS预后不良的独立因素。接受酪氨酸激酶抑制剂(TKI)作为一线或二线治疗的患者之间没有观察到差异。同样,TKI和免疫疗法作为二线治疗也没有区别。总之,sRCC是一种罕见的RCC变体,预后差,对治疗反应差。需要更大规模的前瞻性研究来确定最佳的治疗方法,以延长这种侵袭性变异的生存期。
Real-life experience of patients with sarcomatoid renal cell carcinoma: a multicenter retrospective study.
Sarcomatoid renal cell carcinoma (sRCC) is a rare variant of renal cell carcinoma (RCC) and is associated with a poor prognosis. We reviewed the outcomes of patients from oncology centers in Turkey. Our aim is to share our real-life experience and to contribute to the literature. The demographic and clinical features, treatment, and survival outcomes of 148 patients with sRCC were analyzed. The median age at the time of diagnosis was 58 years (range: 19-83 years). Most patients (62.8%) had clear-cell histology. Most patients were in the intermediate Memorial Sloan-Kettering Cancer Center (MSKCC) risk group (67.6%) and were stage 4 at the time of diagnosis (63.5%). The most common sites of metastasis were the lung (60.1%), lymph nodes (47.3%), and bone (35.8%). The patients received a median of two lines (range: 0-6) of treatment. The most common side effects were fatigue, hematological side effects, hypertension, and hypothyroidism. The median follow-up was 20.9 months (range: 1-162 months). The median overall survival (OS) was 30.8 months (95% confidence interval: 24.9-36.7 months). In multivariate analysis, high MSKCC scores, sarcomatoid differentiation rates >50%, having stage 4 disease, and having lung metastasis at the time of diagnosis were independent factors for poor prognosis affecting OS. No difference was observed between patients who received tyrosine kinase inhibitor (TKI) as the first or second-line treatments. Similarly, no difference between TKI and immunotherapy as the second-line treatment. In conclusion, sRCC is a rare variant of RCC with a poor prognosis and response to treatment. Larger-scale prospective studies are needed to define an optimal treatment approach for longer survival in this aggressive variant.