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Prognostic factors of metastatic renal cell carcinoma with extensive sarcomatoid component

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An Erratum to this article was published on 10 August 2013

Abstract

Purpose

To evaluate clinical characteristics including the response to targeted therapy, the benefits of cytoreductive nephrectomy, or the prognostic factors in advanced renal cell carcinoma (RCC) with extensive sarcomatoid component (ESC), a rare but fatal disease.

Methods

Data from 37 consecutive patients with metastatic or recurrent RCC with ESC (≥25 % on resected kidney or exclusive sarcomatoid histology on needle biopsy) were analyzed.

Results

Of the 37 patients, 27 patients (73 %) had synchronous metastatic disease. The median percentage of sarcomatoid component (PSC) was 50 % (range 25–93 %). Twenty (74 %) of the 27 synchronous metastatic patients underwent cytoreductive nephrectomy. Of the nine patients undergoing cytokine therapy, none showed objective responses. Two (15 %) of the 13 patients undergoing targeted agent therapy had partial responses, and five patients (38 %) achieved stable disease. The median overall survival for all patients was 5.9 months [95 % confidence interval (CI) 1.0–10.9]. In multivariate analysis, age (>58 years), ECOG performance status (>1), PSC (>50 %), and time from first diagnosis to advanced disease (<6 months) remained independent prognostic factors. Neither the type of systemic therapy nor cytoreductive nephrectomy had an effect on survival.

Conclusions

Patients with RCC with ESC have a dismal clinical course, and the majority of patients have rapid disease progression, especially in response to immunotherapy. Four clinical factors can be used to model survival outcomes for advanced RCC with ESC and may be helpful in selecting patients for aggressive treatment.

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Acknowledgments

This study was supported by grants (Grant Numbers: A070001 and A102059) from the Korea Healthcare Technology R&D Project, Ministry of Health, Welfare and Family Affairs, and Converging Research Center Program of the Ministry of Education, Science and Technology (Project Number: 2011K000871), Republic of Korea.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Oncology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-gu, Seoul, 138-736, Korea

    Inkeun Park, Jae-Lyun Lee, Jin-Hee Ahn & Dae-Ho Lee

  2. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Yong Mee Cho

  3. Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Cheryn Song, Jun-Hyuk Hong, Choung-Soo Kim & Hanjong Ahn

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  1. Inkeun Park
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Correspondence to Jae-Lyun Lee.

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Park, I., Cho, Y.M., Lee, JL. et al. Prognostic factors of metastatic renal cell carcinoma with extensive sarcomatoid component. J Cancer Res Clin Oncol 139, 817–827 (2013). https://doi.org/10.1007/s00432-013-1386-4

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  • DOI: https://doi.org/10.1007/s00432-013-1386-4

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