Dr. Daugherty and his team used the SEER-18 registry database to obtain information from 2010-2014 on patients that were diagnosed with only metastatic RCC. They further separated these patients to those with isolated brain metastasis and those with additional/alternative organ metastases.
From a cohort of 6,328 patients, CN was performed 35% of the time. In the entire cohort 12.3% of patients had brain metastasis and only 8% of these patients underwent CN. However, they found the rate of CN in patients with isolated brain metastasis was 32.6% with an overall survival of 33 months whereas the overall survival of patients with brain metastasis and no CN was only 3 months. Interestingly, patients with brain metastasis were often found to have lung metastasis as well (p < 0.05) but not liver or bone metastasis.
Dr. Daugherty concludes that although brain metastasis only includes 12% of all metastatic cases and is generally a poor prognostic factor, not all brain metastases are the same. Those patients with isolated brain metastasis stand to benefit from CN in long-term survival. These findings can assist urologists in patient counselling and appropriate patient selection for CN.
Presented by: Michael Daugherty, MD
Written by: Egor Parkhomenko, Department of Urology, University of California-Irvine at the 2018 AUA Annual Meeting - May 18 - 21, 2018 – San Francisco, CA USA