Analysis of survival rates and evaluation of prognostic factors in patients with bone metastases of renal cancer

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Abstract

Background. In patients with bone metastases of renal cell cancer (RCC), the search for new prognostic factors affecting survival rates is necessary.

Aim. To analyze survival rates and identify prognostic factors in patients with RCC metastases in the bones.

Materials and methods. A retrospective analysis of data of 350 patients with bone metastases of RCC treated at the Moscow City Oncologic Hospital No. 62 and the City Clinical Oncologic Dispensary (Saint Petersburg) from 2006 to 2022 was performed. 117 (33.4 %) patients were classified into the group of intermediate prognosis, 169 (48.3 %) – into the group of poor prognosis. The study investigated clinical and morphologic prognostic factors affecting survival rates in patients with bone metastases of RCC. Statistical analysis was performed using Statistica 10.0 software packages (StatSoft, USA) through construction of Kaplan–Meier curves and survival tables, development of a mathematical model of survival.

Results and conclusion. 3-year, 5-year overall survival (OS) of patients with RCC bone metastases was 38 % (95 % confidence interval (CI) 33–44) and 23 % (95 % CI 18–28), respectively, with a median OS of 28.3 months (95 % CI 23.6–32.9) (p <0.001).

In single factor analysis, ECOG (Eastern Cooperative Oncology Group) status (p <0.001), Fuhrman tumor differentiation grade (p <0.001), type and number of metastases (p <0.001), metastases to the lung (p = 0.027), liver (p = 0.013) and lymph nodes (p <0.001), IMDC (International Metastatic RCC Database Consortium) prognosis (p <0.001), radiation therapy (p = 0.003) and nephrectomy (p <0.001) affected OS in patients with bone metastases of RCC. In multivariate analysis, ECOG status, Fuhrman tumor differentiation degree, type and number of metastases, radiotherapy and nephrectomy were additional factors affecting OS in patients with RCC bone metastases (p <0.001).

About the authors

D. V. Semenov

Saint Petersburg State University;
City Clinical Oncological Dispensary

Author for correspondence.
Email: sema.69@mail.ru
ORCID iD: 0000-0002-4335-8446

Dmitriy Vladimirovich Semenov   

7–9 Universitetskaya Naberezhnaya, Saint Petersburg 199034; 
56 Veteranov Prospekt, Saint Petersburg 198255

                        

Russian Federation

R. V. Orlova

Saint Petersburg State University;
City Clinical Oncological Dispensary

ORCID iD: 0000-0002-9368-5517

7–9 Universitetskaya Naberezhnaya, Saint Petersburg 199034; 
56 Veteranov Prospekt, Saint Petersburg 198255

V. I. Shirokorad

Moscow City Oncology Hospital No. 62, Moscow Healthcare Department

ORCID iD: 0000-0003-4109-6451

27 Istra, Moscow Region 143423

S. V. Kostritsky

Moscow City Oncology Hospital No. 62, Moscow Healthcare Department

ORCID iD: 0000-0003-4494-1489

27 Istra, Moscow Region 143423

References

  1. Capitanio U., Bensalah K., Bex A. et al. Epidemiology of renal cell carcinoma. Eur Urol 2019;75(1):74–84. doi: 10.1016/j.eururo.2018.08.036
  2. Dabestani S., Thorstenson A., Lindblad P. et al. Renal cell carcinomarecurrences and metastases in primarynon-metastatic patients: a population-based study. World J Urol 2016;34(8):1081–6. doi: 10.1007/s00345-016-1773-y
  3. Bianchi M., Sun M., Jeldres C. et al. Distributionof metastatic sites in renal cell carcinoma: a population-based analysis. Ann Oncol 2012;23(4):973–80. doi: 10.1093/annonc/mdr362
  4. Chandrasekar T., Klaassen Z., Goldberg H. et al. Metastatic renal cell carcinoma: patterns and predictors ofmetastases-A contemporary population-based series. Urol Oncol 2017;35(11):661e7–14. doi: 10.1016/j.urolonc.2017.06.060
  5. Dudani S., de Velasco G., Wells J.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
  6. Heng D.Y., Xie W., Bjarnason G.A. et al. Progression-free survival as a predictor of overall survival in metastatic renal cell carcinoma treated with contemporary targeted therapy. Cancer 2011;117(12):2637–42. doi: 10.1002/cncr.25750
  7. Esposito M., Guise T., Kang Y. The biology of bone metastasis. Cold Spring Harb Perspect Med 2018;8(6):a031252. doi: 10.1101/cshperspect.a031252
  8. Chen S.C., Kuo P.L. Bone metastases from renal cell carcinoma. Int J Mol Sci 2016;17:987. doi: 10.3390/ijms17060987
  9. Woodward E., Jagdev S., McParland L. et al. Skeletal complications and survival in renal cancer patients with bone metastases. Bone 2011;48(1):160–6. doi: 10.1016/j.bone.2010.09.008
  10. McKay R.R., Kroeger N., Xie W. et al. Impact of bone and liver metastases on patients with renal cell carcinoma treated with targeted therapy. Eur Urol 2014;65(3):577–84. doi: 10.1016/j.eururo.2013.08.012
  11. Lin P.P., Mirza A.N., Lewis V.O. et al. Patient survival after surgery for osseous metastases from renal cell carcinoma. J Bone Joint Surg Am 2007;89(8):1794–801. doi: 10.2106/JBJS.F.00603
  12. Fottner A., Szalantzy M., Wirthmann L. et al. Bone metastases from renal cell carcinoma: patient survival after surgical treatment. BMC Musculoskelet Disord 2010;11:145. doi: 10.1186/1471-2474-11-145
  13. Wood S.L., Brown J.E. Skeletal metastasis in renal cell carcinoma: current and future management options. Cancer Treat Rev 2012;8(4):284–91. doi: 10.1016/j.ctrv.2011.06.011
  14. Kinget L., Roussel E., Lambrechts D. et al. MicroRNAspossibly involved in the development of bone metastasis in clear-cell renal cell carcinoma. Cancers (Basel) 2021;13(7):1554. doi: 10.3390/cancers13071554
  15. Ruatta F., Derosa L., Escudier B. et al. Prognosis of renal cell carcinoma with bone metastases: experience from a large cancer centre. Eur J Cancer 2019;107:79–85. doi: 10.1016/j.ejca.2018.10.023
  16. Escudier B., Powles T., Motzer R.J. et al. Cabozantinib, a new standard of care for patients with advanced renal cell carcinoma and bone metastases? Subgroup analysis of the METEOR trial. J Clin Oncol 2018;36(8):765–72. doi: 10.1200/JCO.2017.74.7352
  17. Huang Z., Du Y., Zhang X. et al. Clear cell renal cell carcinoma bone metastasis: what should be considered in prognostic evaluation. Eur J Surg Oncol 2019;45:1246–52. doi: 10.1016/j.ejso.2019.01.221
  18. Gudbjartsson T., Hardarson S., Petursdottir V. et al. Histological subtyping and nuclear grading of renal cell carcinoma and their implications for survival: a retrospective nation-wide study of 629 patients. Eur Urol 2005;48(4):593–600. doi: 10.1016/j.eururo.2005.04.016
  19. Ficarra V., Martignoni G., Maffei N. et al. Original and reviewed nuclear grading according to the Fuhrman system: a multivariate analysis of 388 patients with conventional renal cell carcinoma. Cancer 2005;103(1):68–75. doi: 10.1002/cncr.20749
  20. Gerlinger M., Rowan A.J., Horswell S. et al. Intratumor heterogeneity and branched evolution revealed by multiregion sequencing. N Engl J Med 2012;366:883–92. doi: 10.1056/nejmoa1113205
  21. Zhou H., Yang S., Xie T. et al. Risk factors, prognostic factors, and nomograms for bone metastasis in patients with newly diagnosed clear cell renal cell carcinoma: a large population-based study. Front Surg 2022:9:877653. doi: 10.3389/fsurg.2022.877653
  22. Yue G., Deyu L., Lianyuan T. et al. Clinical features and prognostic factors of patients with metastatic renal cell carcinoma stratified by age. Aging 2021;13(6):8290–305. doi: 10.18632/aging.202637
  23. Zhang Z., Liang C., Hou B., Zhou L. Population-based evaluation of the risk factors and prognosis among renal cell carcinoma patients with initially diagnosed lung metastases. Actas Urol Esp 2021;45(7):498–506. doi: 10.1016/j.acuro.2020.06.014
  24. Chen X.Y., Lan M., Zhou Y. et al. Risk factors for bone metastasis from renal cell cancer. J Bone Oncol 2017;9:29–33. doi: 10.1016/j.jbo.2017.10.004
  25. Guo Q., Zhang C., Guo X. et al. Incidence of bone metastasis and factors contributing to its development and prognosis in newly diagnosed renal cell carcinoma: a population-based study. Cancer Manag Res 2018;10:2935–44. doi: 10.2147/cmar.S170083
  26. Fan Z., Huang Z., Huang X. Bone metastasis in renal cell carcinoma patients: risk and prognostic factors and nomograms. J Oncol 2021;2021:5575295. doi: 10.1155/2021/5575295
  27. Kang H.W., Seo S.P., Kim W.T. et al. Impact of young age at diagnosis on survival in patients with surgically treated renal cell carcinoma: a multicenter study. J Korean Med Sci 2016;31(12):1976–82. doi: 10.3346/jkms.2016.31.12.1976
  28. Тompson R.H., Ordonez M.A., Iasonos A. et al. Renal cell carcinoma in young and old patients-is there a difference? J Urol 2008;180(4):1262–6. doi: 10.1016/j.juro.2008.06.037
  29. Dong S. Yang H., Tang Z.R. et al. Development and validation of a predictive model to evaluate the risk of bone metastasis in kidney cancer. Front Oncol 2021;11:731905. doi: 10.3389/fonc.2021.731905
  30. Xue J., Chen W., Xu W. et al. Patterns of distant metastases in patients with clear cell renal cell carcinoma – a population-based analysis. Cancer Med 2021;10(1):173–87. doi: 10.1002/cam4.3596
  31. Santoni M., Conti A., Procopio G. et al. Bone metastases in patients with metastatic renal cell carcinoma: are they always associated with poor prognosis? J Exp Clin Cancer Res 2015;34(1):10. doi: 10.1186/s13046-015-0122-0
  32. Grünwald V., Eberhardt B., Bex A. et al. An interdisciplinary consensus on the management of bone metastases from renal cell carcinoma. Nat Rev Urol 2018;15(8):511–21. doi: 10.1038/s41585-018-0034-9
  33. Nieder C., Pawinski A., Dalhaug A. Continuous controversy about radiation oncologists’ choice of treatment regimens for bone metastases: should we blame doctors, cancer-related features, or design of previous clinical studies? Radiat Oncol 2013;8:85. doi: 10.1186/1748-717X-8-85
  34. Szendroi A., Dinya E., Kardos M. et al. Prognostic factors and survival of renal clear cell carcinoma patients with bone metastases. Pathol Oncol Res 2010;16(1):29–38. doi: 10.1007/s12253-009-9184-7
  35. Casadei R., Drago G., Di Pressa F., Donati D. Humeral metastasis of renal cancer: Surgical options and review of literature. Orthop Traumatol Surg Res 2018;104:533–8. doi: 10.1016/j.otsr.2018.03.009

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