Prognostic Factors for Survival in Patients with Metastatic Renal Cancer Treated with Biological Response Modifiers
- 1 July 1995
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 154 (1), 35-40
- https://doi.org/10.1016/s0022-5347(01)67218-5
Abstract
Clinical characteristics prognostic of survival in patients with metastatic renal cell carcinoma treated with biological response modifiers are poorly understood. Understanding these prognostic features may help with better stratification of patients in clinical trials and define further appropriate treatment for each prognostic subgroup.A retrospective study of 84 patients with recurrent or metastatic renal cancer was conducted to identify prognostic factors for survival in patients who received biological response modifiers (alpha-interferon, beta-interferon, gamma-interferon and interleukin-2).Univariate analysis identified Eastern Cooperative Oncology Group (ECOG) performance status (1 versus 0, p < 0.001), bone metastasis (p = 0.008), recent weight loss (greater than 10% of total body weight versus no loss, p = 0.028), history of nephrectomy (no versus yes, p = 0.025), recurrence at the renal bed (p = 0.043) and sarcomatoid histology (yes versus no, p < 0.001) as important prognostic indicators. Multivariate analysis of prognostic factors in this patient population indicated that ECOG performance status, sarcomatoid histology and bone metastasis were most significant, while other factors were less significant (p > 0.05) after adjusting for ECOG performance status and sarcomatoid histology. Based on the total positive number of 5 risk factors defined previously the study population separates into 3 risk groups, with a median survival from the low to high risk groups of 14.4, 10.9 and 1.3 months, respectively. Prognostic scores based only on ECOG performance status, sarcomatoid histology and bone metastasis allowed for stratification of our patients into 3 distinct groups with median survivals of 18.6, 8.4 and 3.8 months, which were also predictive of survival (p < 0.05).Risk factors of ECOG performance status, sarcomatoid histology, bone metastasis, history of nephrectomy, recent weight loss and recurrence at the renal bed are predictive of survival in patients treated with biological response modifiers. In addition to previous findings of prognostic factors in renal cancer patients treated with chemotherapy, we identified sarcomatoid histology as an important risk factor in patients treated with biological response modifiers.Keywords
This publication has 22 references indexed in Scilit:
- Clinical immunotherapy studies in the surgery branch of the U.S. National Cancer Institute: brief reviewCancer Treatment Reviews, 1989
- Phase II trials of 5-day vinblastine infusion (NSC 49842), L-alanosine (NSC 153353), acivicin (NSC 163501), and aminothiadiazole (NSC 4728) in patients with recurrent or metastatic renal cell carcinomaInvestigational New Drugs, 1988
- Metastatic Renal Cancer Treated with Interleukin-2 and Lymphokine-Activated Killer CellsAnnals of Internal Medicine, 1988
- Intrinsic drug resistance in human kidney cancer is associated with expression of a human multidrug-resistance gene.Journal of Clinical Oncology, 1987
- A Progress Report on the Treatment of 157 Patients with Advanced Cancer Using Lymphokine-Activated Killer Cells and Interleukin-2 or High-Dose Interleukin-2 AloneNew England Journal of Medicine, 1987
- Phase II trial of misonidazole (MISO) and cyclophosphamide (CYC) in metastatic renal cell carcinomaInternational Journal of Radiation Oncology*Biology*Physics, 1986
- Human lymphoblastoid interferon therapy for advanced renal cell carcinomaUrology, 1984
- Phase II study of PALA and AMSA in advanced renal cell carcinomaAmerican Journal of Clinical Oncology, 1983
- Renal Cell Carcinoma: Natural History and Results of TreatmentJournal of Urology, 1978
- An evaluation of postoperative radiotherapy in hypernephroma treatment—A clinical trialCancer, 1973