Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma Journal Article

Authors: Motzer, R. J.; Bacik, J.; Schwartz, L. H.; Reuter, V.; Russo, P.; Marion, S.; Mazumdar, M.
Article Title: Prognostic factors for survival in previously treated patients with metastatic renal cell carcinoma
Abstract: Purpose: To describe survival in previously treated patients with metastatic renal cell carcinoma (RCC) who are candidates for clinical trials of new agents as second-line therapy. Patients and Methods: The relationship between pretreatment clinical features and survival was studied in 251 patients with advanced RCC treated during 29 consecutive clinical trials between 1975 and 2002. Clinical features were first examined in univariate analyses, and then a stepwise modeling approach based on Cox regression was used to form a multivariate model. Results: Median survival for the 251 patients was 10.2 months and differed according to year of treatment, with patients treated after 1990 showing longer survival. In this group, the median overall survival time was 12.7 months. Because the purpose of this analysis was to establish prognostic factors for present-day clinical trial design, prognostic factor analysis was performed on these patients. Pretreatment features associated with a shorter survival in the multivariate analysis were low Karnofsky performance status, low hemoglobin level, and high corrected serum calcium. These were used as risk factors to categorize patients into three different groups. The median time to death in patients with zero risk factors was 22 months. The median survival in patients with one of these prognostic factors was 11.9 months. Patients with two or three risk factors had a median survival of 5.4 months. Conclusion: Treatment with novel agents during a clinical trial is indicated for patients with metastatic RCC after progression to cytokine treatment. Three prognostic factors for predicting survival were used to categorize patients into risk groups. These risk categories can be used in clinical trial design and interpretation. © 2004 by American Society of Clinical Oncology.
Keywords: adolescent; adult; cancer survival; controlled study; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; major clinical study; clinical feature; clinical trial; mortality; antineoplastic agents; antineoplastic agent; metabolism; metastasis; tumor markers, biological; calcium; hemoglobin; calcium blood level; pathology; retrospective study; tumor marker; risk factor; kidney carcinoma; kidney neoplasms; cancer mortality; cytokine; blood; karnofsky performance status; kidney tumor; carcinoma, renal cell; lactate dehydrogenase; multivariate analysis; l-lactate dehydrogenase; hemoglobins; clinical trials; hemoglobin determination; humans; prognosis; human; male; female; priority journal; article
Journal Title: Journal of Clinical Oncology
Volume: 22
Issue: 3
ISSN: 0732-183X
Publisher: American Society of Clinical Oncology  
Date Published: 2004-02-01
Start Page: 454
End Page: 463
Language: English
DOI: 10.1200/jco.2004.06.132
PROVIDER: scopus
PUBMED: 14752067
Notes: J. Clin. Oncol. -- Cited By (since 1996):403 -- Export Date: 16 June 2014 -- CODEN: JCOND -- Source: Scopus
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MSK Authors
  1. Paul Russo
    446 Russo
  2. Robert Motzer
    744 Motzer
  3. Madhu Mazumdar
    120 Mazumdar
  4. Lawrence H Schwartz
    281 Schwartz
  5. Victor Reuter
    900 Reuter
  6. Jennifer M Bacik
    46 Bacik
  7. Stephanie Marion
    8 Marion