Molecular Subtypes of Clear-cell Renal Cell Carcinoma are Prognostic for Outcome After Complete Metastasectomy

European Urology
Annelies VerbiestBenoit Beuselinck

Abstract

Metastasectomy is routinely performed in selected patients with metastatic clear-cell renal cell carcinoma (ccRCC) as an alternative to systemic therapy. In the absence of randomized trials, the benefit and best way of patient selection remain unclear. Earlier, we described four molecular ccRCC-subtypes (ccrcc1-4) that have a prognostic and predictive value upon first-line sunitinib or pazopanib. Assess the prognostic value of ccrcc1-4 subtypes after complete metastasectomy. (1) Compare outcomes of good-prognosis ccrccc2&3-tumors with intermediate/poor-prognosis ccrcc1&4-tumors. (2) Compare outcomes of the four subtypes separately. Single-center retrospective study (1995-2017), assessing 43 ccRCC patients undergoing complete metastasectomy without systemic treatment. Molecular subtype determined with established 35-gene expression classifier. Median disease-free survival (DFS), time to systemic therapy, cancer-specific (CSS) and overall survival (OS) from metastasectomy, estimated with Kaplan-Meier method and tested against other predictors with multivariable Cox regression. Median DFS was 23 mo for ccrcc2&3-tumors versus 9 mo for ccrcc1&4-tumors (p=0.011, hazard ratio [HR]=2.6). Median time to systemic therapy was 92 mo versus...Continue Reading

Citations

Mar 7, 2018·Nature Reviews. Urology·Rebecca Kelsey
May 28, 2020·Journal of Clinical Medicine·Antonella ArgentieroNicola Silvestris
Jan 11, 2020·Frontiers in Oncology·Carmine D'AnielloGaetano Facchini
May 29, 2020·Current Opinion in Urology·Sara OmidMesut Remzi
Sep 19, 2019·Cancer Discovery·Lynda VuongA Ari Hakimi
Jun 24, 2019·Clinical Genitourinary Cancer·Annelies VerbiestBenoit Beuselinck
May 20, 2021·Computer Methods and Programs in Biomedicine·Saeed PirmoradiArash Sharifi

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