Prognostic Factors for Survival in Metastatic Renal Cell Carcinoma

Abstract

Despite recent advances in treatment, metastatic renal cell carcinoma remains incurable. The poor outlook for these patients coupled with the disease’s variable natural history makes the identification and understanding of the factors that impact outcome an important consideration for patient care, the development of new therapies, and study planning and interpretation, Numerous well designed retrospective studies examining clinical factors have been conducted over the past two decades. Although there is no consensus on which set of factors is best, performance status is perhaps the most important clinical factor identified to date. It is a subjective measure of overall health, yet it has consistently, albeit not universally, been shown to have excellent prognostic value in numerous studies. With the exception of performance status most studies have examined different combination of factors, used varying definitions, and/or treated different patient populations, and therefore, it is difficult to fully assess their value as independent prognostic indicators.

In addition to these “classical” predictors, new molecular based technologies are helping to better define the biology of renal cell carcinoma and identify new prognostic factors. Their value as independent prognostic indicators however needs to be confirmed by evaluating them in homogeneous patient groups and in conjunction with the more classical predictors.