- Email: [email protected]
Bone Metastases from Rcc are not Always Associated with a Poor Prognosis
Annals of Oncology 25 (Supplement 4): iv280–iv304, 2014 doi:10.1093/annonc/mdu337.21
genitourinary tumours, non-prostate 828P
BONE METASTASES FROM RCC ARE NOT ALWAYS ASSOCIATED WITH A POOR PROGNOSIS
abstracts
Aim: Bone represents an unfavorable site of metastasis for renal cell carcinoma (mRCC), being associated with poorer prognosis compared to other metastatic sites. Aim of this study was to investigate for the presence of existing prognostic factors in patients with bone metastases from RCC. Methods: Data of patients with bone metastases from RCC were retrospectively collected from 16 Italian centers. Survival estimates were quantified using Kaplan Meier curves. Age, sex, ECOG-Performance Status (PS), MSKCC group, tumor histology, presence of visceral metastases, time from nephrectomy to bone metastasis (classified into three groups: <1 year, between 1 and 5 years and >5 years) and time from bone metastasis to skeletal-related event (SRE) were included in the Cox analysis to investigate their prognostic relevance. Results: 470 patients were enrolled in this analysis; 235 of them were male. Median age was 64y (30-92y). In 19 patients (4%), bone was the only metastatic site; 277 patients (59%) had concomitant lung, 188 (40%) lymph nodes, 83 (18%) liver, 32 (7%) brain, and 12 (3%) adrenal metastases. Median time to bone metastasis was 16 months (range 0–44y). Median OS from bone disease was 17 months (95%CI:15-19 months). Number of metastatic sites ( p = 0.01), concomitant metastases to liver ( p = 0.006) and lymph-nodes ( p = 0.02), high Fuhrman grade ( p < 0.001) and non-clear cell histology ( p = 0.013) were significantly associated with poor prognosis. Patients with late-relapsing (>5y) bone metastases had longer OS (22 months, 95%CI: 20-33) compared to patients with bone disease occurred <1y (13 months, 95%CI: 12-15) or between 1 and 5y (19 months, 95%CI: 12-26) from nephrectomy ( p < 0.001), while no difference was found between these two last groups ( p = 0.18). At multivariate analysis, ECOG-PS, MSKCC group and concomitant liver, lung or lymph node metastases resulted as independent predictors of OS in patients with bone disease. Conclusions: The prognosis of RCC patients with bone metastases varies according to RCC histology, time of occurrence of bone metastases, presence of concomitant sites, MSKCC group and ECOG-PS. Disclosure: All authors have declared no conflicts of interest.
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_4/iv288/2241545 by guest on 26 October 2019
D. Santini1, M. Santoni2, A. Conti2, G. Procopio3, C. Porta4, T. Ibrahim5, S. Barni6, A. Fontana7, A. Berruti8, B. Vincenzi1, C. Ortega9, G. Carteni10, S.L. Fedeli11, V. Adamo12, E. Maiello13, R. Sabbatini14, A. Felici15, G. Tonini1, S. Bracarda16, S. Cascinu17 1 Medical Oncology, Campus Bio-Medico di Roma, Rome, ITALY 2 Clinica di Oncologia Medica, AO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, ITALY 3 Oncologia Medica, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, ITALY 4 Oncologia Medica, Ospedale San Matteo, Pavia, ITALY 5 Oncology, Istituto Tumori della Romagna I.R.S.T., Forli, ITALY 6 Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, ITALY 7 U.O. Oncologia Medica 2 Universitaria, Polo Oncologico, Ospedale S. Chiara, AOUP, Pisa, ITALY 8 Oncologia Medica, Azienda Spedali Civili, Brescia, ITALY 9 Medical Oncology, IRCC - Fondazione Piemontese per la Ricerca sul Cancro, Candiolo, ITALY 10 Onco-hematology, Azienda Ospedaliera Cardarelli, Naples, ITALY 11 Medical Oncology, Ospedali Riuniti Marche Nord, Pesaro, ITALY 12 Human Pathology, AOOR Papardo-Piemonte, Messina, ITALY 13 Medical Oncology, Ospedale Casa Sollievo della Sofferenza, S.Giovanni Rotondo, ITALY 14 Medical Oncology, Ospedale Policlinico-Modena, Modena, ITALY 15 Divisione di Oncologia Medica A, Istituto Nazionale Tumori Regina Elena, Rome, ITALY 16 Department of Oncology, Ospedale San Donato and U.O.C. of Medical Oncology, Arezzo, ITALY 17 Dipartimento di Medicina Clinica e Biotecnologie A, AOU Ospedali Riuniti
Ancona Università Politecnica delle Marche, Ancona, ITALY
genitourinary tumours, non-prostate 828P
BONE METASTASES FROM RCC ARE NOT ALWAYS ASSOCIATED WITH A POOR PROGNOSIS
abstracts
Aim: Bone represents an unfavorable site of metastasis for renal cell carcinoma (mRCC), being associated with poorer prognosis compared to other metastatic sites. Aim of this study was to investigate for the presence of existing prognostic factors in patients with bone metastases from RCC. Methods: Data of patients with bone metastases from RCC were retrospectively collected from 16 Italian centers. Survival estimates were quantified using Kaplan Meier curves. Age, sex, ECOG-Performance Status (PS), MSKCC group, tumor histology, presence of visceral metastases, time from nephrectomy to bone metastasis (classified into three groups: <1 year, between 1 and 5 years and >5 years) and time from bone metastasis to skeletal-related event (SRE) were included in the Cox analysis to investigate their prognostic relevance. Results: 470 patients were enrolled in this analysis; 235 of them were male. Median age was 64y (30-92y). In 19 patients (4%), bone was the only metastatic site; 277 patients (59%) had concomitant lung, 188 (40%) lymph nodes, 83 (18%) liver, 32 (7%) brain, and 12 (3%) adrenal metastases. Median time to bone metastasis was 16 months (range 0–44y). Median OS from bone disease was 17 months (95%CI:15-19 months). Number of metastatic sites ( p = 0.01), concomitant metastases to liver ( p = 0.006) and lymph-nodes ( p = 0.02), high Fuhrman grade ( p < 0.001) and non-clear cell histology ( p = 0.013) were significantly associated with poor prognosis. Patients with late-relapsing (>5y) bone metastases had longer OS (22 months, 95%CI: 20-33) compared to patients with bone disease occurred <1y (13 months, 95%CI: 12-15) or between 1 and 5y (19 months, 95%CI: 12-26) from nephrectomy ( p < 0.001), while no difference was found between these two last groups ( p = 0.18). At multivariate analysis, ECOG-PS, MSKCC group and concomitant liver, lung or lymph node metastases resulted as independent predictors of OS in patients with bone disease. Conclusions: The prognosis of RCC patients with bone metastases varies according to RCC histology, time of occurrence of bone metastases, presence of concomitant sites, MSKCC group and ECOG-PS. Disclosure: All authors have declared no conflicts of interest.
© European Society for Medical Oncology 2014. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected].
Downloaded from https://academic.oup.com/annonc/article-abstract/25/suppl_4/iv288/2241545 by guest on 26 October 2019
D. Santini1, M. Santoni2, A. Conti2, G. Procopio3, C. Porta4, T. Ibrahim5, S. Barni6, A. Fontana7, A. Berruti8, B. Vincenzi1, C. Ortega9, G. Carteni10, S.L. Fedeli11, V. Adamo12, E. Maiello13, R. Sabbatini14, A. Felici15, G. Tonini1, S. Bracarda16, S. Cascinu17 1 Medical Oncology, Campus Bio-Medico di Roma, Rome, ITALY 2 Clinica di Oncologia Medica, AO Ospedali Riuniti, Università Politecnica delle Marche, Ancona, ITALY 3 Oncologia Medica, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milan, ITALY 4 Oncologia Medica, Ospedale San Matteo, Pavia, ITALY 5 Oncology, Istituto Tumori della Romagna I.R.S.T., Forli, ITALY 6 Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, Treviglio, ITALY 7 U.O. Oncologia Medica 2 Universitaria, Polo Oncologico, Ospedale S. Chiara, AOUP, Pisa, ITALY 8 Oncologia Medica, Azienda Spedali Civili, Brescia, ITALY 9 Medical Oncology, IRCC - Fondazione Piemontese per la Ricerca sul Cancro, Candiolo, ITALY 10 Onco-hematology, Azienda Ospedaliera Cardarelli, Naples, ITALY 11 Medical Oncology, Ospedali Riuniti Marche Nord, Pesaro, ITALY 12 Human Pathology, AOOR Papardo-Piemonte, Messina, ITALY 13 Medical Oncology, Ospedale Casa Sollievo della Sofferenza, S.Giovanni Rotondo, ITALY 14 Medical Oncology, Ospedale Policlinico-Modena, Modena, ITALY 15 Divisione di Oncologia Medica A, Istituto Nazionale Tumori Regina Elena, Rome, ITALY 16 Department of Oncology, Ospedale San Donato and U.O.C. of Medical Oncology, Arezzo, ITALY 17 Dipartimento di Medicina Clinica e Biotecnologie A, AOU Ospedali Riuniti
Ancona Università Politecnica delle Marche, Ancona, ITALY