Namık Kemal Tıp Dergisi (Sep 2024)
Prognostic Factors and Treatment Outcomes in Renal Cell Carcinoma: A Comprehensive Analysis
Abstract
Aim: We aimed to investigate the prognostic factors, factors affecting survival and the prognostic value of the Memorial Sloan-Kettering Cancer Centre (MSKCC) risk score in renal cell carcinoma (RCC) patients. In addition, we assessed the survival and potential adverse effects of sunitinib and pazopanib tyrosine kinase inhibitors. Materials and Methods: The study included patients diagnosed with RCC aged ≥18 years, who were followed up in our clinic between 2006 and 2020. The clinicopathological characteristics were recorded in the hospital’s electronic data system. In the entire patient population, survival and prognostic factors were investigated. Furthermore, prognostic factors in terms of treatment (pazopanib vs. sunitinib) for advanced stage patients were evaluated as well. Results: Two hundred and two patients were included in this study. Fifty-five of the patients were female, 147 patients were male. Most common histological type was clear cell carcinoma (59%). At the time of presentation, 57% of the patients were in the early stage (stage 1,2,3). The median overall survival (mOS) was 16.8 months in stage 4 patients and 82.5 months in early stage patients. mOS was 69.1 months in the favorable MSKCC risk group while it was 6.8 months in the poor risk group. In the sunitinib arm, the median progression-free survival (mPFS) was 11.1 months, and mOS was 18.1 months. In the pazopanib arm, mPFS was 12.2 months, and mOS was 17.4 months. There was no significant difference in response rate, mPFS, and mOS between the two drugs. Conclusion: In this study, we have shown that risk and performance scorings with some laboratory and clinical evaluations, which are still cheap and easily accessible, are valuable and usable in showing prognosis in RCC patients. Disease stage, MSKCC risk score, Eastern Cooperative Oncology Group, and Karnofsky performance scores showed prognostic characteristics in RCC. There was no survival difference between histological subtypes. The efficacy of sunitinib and pazopanib in metastatic first-line treatment was similar, but pazopanib was superior in terms of any grade adverse events.
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