Overall survival was associated with both metastatic involvement and histologic subtypes of renal cell carcinoma (RCC), according to findings of a multicenter, international cohort study, published in JAMA Network Open.

Biologic and clinical variability between histologic subtypes of RCC is significant. However, data on metastasis among the subtypes is sparse. Therefore, researchers sought to characterize sites of metastasis and their association with survival in the 3 most common subtypes of mRCC. Patient data from 10,105 patients with metastatic RCC collected between 2005 and 2019 at 40 different centers, included in the International Metastatic RCC Database Consortium, were analyzed for this study. Metastatic site involvement and overall survival were associated with histological subtypes.

Patients were median age 60 years (interquartile range [IQR], 53 to 67) at diagnosis and 72.4% were men. Cancer types represented included 9252 patients with clear cell RCC (ccRCC), 667 with papillary RCC (pRCC), and 186 with chromophobe RCC (chrRCC). All demographic and clinical characteristics differed significantly on the basis of histological subtype.


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Stratified by subtype, metastasis was most common in the lung among patients with ccRCC (70%) and lymph nodes among patients with pRCC (69%) and chrRCC (51%).

Median survival varied by metastatic involvement, in which patients with metastasis of the pancreas were associated with the longest survival (median, 50.1 months; 95% CI, 41.1-55.5) and lowest among patients with pleura involvement (median, 15.6 months; 95% CI, 13.7-18.8).

Stratified by subtype and metastasis location, the highest median survival among those with lung metastasis was associated with ccRCC (ccRCC: 25.1 vs pRCC: 15.6 vs chrRCC: 14.1 months; P <.001); among those with lymph node metastasis, with chrRCC (chrRCC: 28.1 vs ccRCC: 21.4 vs pRCC: 14.3 months; P <.001); and among those with bone metastasis, with chrRCC (chrRCC: 26.7 vs ccRCC: 19.4 vs pRCC: 11.0 months; P <.001).

This study may have been limited by the patient inclusion in the database which likely did not have many patients with highly favorable or very poor prognoses.

These data indicated patients with metastatic RCC had subtype- and metastasis-associated variation in overall survival rates.

Disclosure: Multiple authors declared affiliations with and/or received funding from the pharmaceutical industry. Please refer to the original article for a full list of disclosures.

Reference

Dudani S, de Velasco G, Wells C, et al. Evaluation of clear cell, papillary, and chromophobe renal cell carcinoma metastasis sites and association with survival. JAMA Netw Open. 2021;4(1):e2021869. doi:10.1001/jamanetworkopen.2020.21869