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

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).

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