AUA 2018: Renal Cell Carcinoma and Brain Metastasis: A SEER Analysis

San Francisco, CA USA ( Dr. Daugherty from SUNY Upstate Medical University presented his groups research focusing on metastatic renal cell carcinoma (RCC). He explained that management decisions are often driven by the site and number of metastases. Brain metastases are considered a poor prognostic factor which typically excludes patients from undergoing cytoreductive nephrectomy (CN). Using the SEER database, his team sought to investigate the outcomes of patients that had brain metastases and underwent CN.

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