To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries.
Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14. 5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method.
Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58).
Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.
JCO global oncology. 2021 May [Epub]
Diego Abreu, Gustavo Carvalhal, Guillermo Gueglio, Ignacio Tobia, Patricio Garcia, Alvaro Zuñiga, Luis Meza, Rubén Bengió, Carlos Scorticati, Ricardo Castillejos, Francisco Rodriguez, Ana María Autran, Carmen Gonzales, Jose Gadu, Alejandro Nolazco, Carlos Ameri, Hamilton Zampolli, Raúl Langenhin, Diego Muguruza, Marcos Tobías Machado, Pablo Mingote, Juan Yandian, Jorge Clavijo, Lucas Nogueira, Omar Clark, Fernando Secin, Agustín Rovegno, Ana Vilas, Enrique Barrios, Ricardo Decia, Gustavo Guimarães, Sidney Glina, Sumanta K Pal, Oscar Rodriguez, Joan Palou, Philippe Spiess, Primo N Lara, W Marston Linehan, Antonio Luigi Pastore, Stenio C Zequi
Servicio de Urología, Hospital Pasteur, Montevideo, Uruguay., Hospital São Lucas da PUCRS, Porto Alegre, Brazil., Hospital Italiano, Buenos Aires, Argentina., Universidad Católica, Santiago de Chile, Chile., Instituto Nacional de Enfermedades Neoplásicas (INEN), Lima, Peru., Clinica Profesor Bengio, Cordoba, Argentina., Hospital de Clínicas, Buenos Aires, Argentina., Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCNSZ), Ciudad de México, Mexico., Fundación Jiménez Díaz, Madrid, Spain., Hospital Militar, Ciudad de México, Mexico., Hospital Británico, Buenos Aires, Argentina., Hospital Alemán, Buenos Aires, Argentina., Instituto Arnaldo Vieira de Carvalho, São Paulo, Brazil., Coperativa Médica de Paysandú (COMEPA), Paysandú, Uruguay., Escuela de Medicina, ABC, São Paulo, Brazil., Policlinico Neuquén, Neuquén, Argentina., Hospital de Clínicas, Montevideo, Uruguay., Universidade de Minas Gerais, Belo Horizonte, Brazil., Hospital Militar, Montevideo, Uruguay., Centro de Educación Médica e Investigaciones Clínicas (CEMIC), Buenos Aires, Argentina., Departamento de Patología, Hospital Pasteur, Montevideo, Uruguay., Departamento de Métodos Cuantitativos, Facultad de Medicina, Montevideo, Uruguay., A.C. Camargo Cancer Center, São Paulo, Brazil., Hospital Ipiranga, São Paulo, Brazil., City of Hope, Duarte, CA., Fundación Puigvert, Barcelona, Spain., Lee Moffitt Cancer Center, Tampa, FL., The University of California Davis Comprehensive Cancer Center, Sacramento, CA., Center for Cancer Research, National Cancer Institute, Bethesda, MD., Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.