Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data

Background: Sarcomatoid differentiation/histology of renal cell carcinoma (sRCC) in patients with metastatic renal cell carcinoma (mRCC) is still underresearched in current therapy regimes. We aimed to evaluate the impact of sRCC on outcomes in patients with mRCC treated with tyrosine kinase inhibit...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Florian Janisch, Christina Kienapfel, Constantin Fühner, Thomas Klotzbücher, Phillip Marks, Tobias Hillemacher, Christian P. Meyer, Takehiro Iwata, Mehdi Kardoust Parizi, Guido Sauter, Margit Fisch, Shahrokh F. Shariat, Roland Dahlem, Michael Rink
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	renal cell carcinoma tyrosine kinase inhibitors targeted therapy sarcomatoid histology therapy regime Surgery RD1-811
Acceso en línea:	https://doaj.org/article/46f83ba3e8464463b86b544dabfebe2d
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:46f83ba3e8464463b86b544dabfebe2d
record_format	dspace
spelling	oai:doaj.org-article:46f83ba3e8464463b86b544dabfebe2d2021-11-18T06:21:44ZTreatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data2296-875X10.3389/fsurg.2021.763271https://doaj.org/article/46f83ba3e8464463b86b544dabfebe2d2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.763271/fullhttps://doaj.org/toc/2296-875XBackground: Sarcomatoid differentiation/histology of renal cell carcinoma (sRCC) in patients with metastatic renal cell carcinoma (mRCC) is still underresearched in current therapy regimes. We aimed to evaluate the impact of sRCC on outcomes in patients with mRCC treated with tyrosine kinase inhibitors (TKIs).Methods: We collected complete data of 262 consecutive mRCC patients from our institutional database for this retrospective study. All patients were treated with TKIs within a single or multimodal treatment approach. All analyses were adjusted for the presence of sRCC. Descriptive statistics as well as uni- and multivariable outcome metrics, including progression-free (PFS) and overall survival (OS) as endpoints were performed.Results: Overall, 18 patients had sRCC (6.9%). Patients with sRCC had more often clear-cell histology (p = 0.047), a higher T-stage (p = 0.048), and underwent cytoreductive nephrectomy more frequently (p < 0.001). The most common first-line TKIs were Sunitinib (65.6%), Sorafenib (19.5%), and Pazopanib (10.3%), respectively. At a median follow-up of 32 months, patients with sRCC had significantly reduced PFS (p = 0.02) and OS (p = 0.01) compared to patients without sRCC. In multivariable analyses that adjusted for the effects of standard mRCC predictors, the sarcomatoid feature retained its independent association with inferior PFS (HR: 2.39; p = 0.007) and OS (HR: 2.37; p = 0.001). This association remained statistically significant in subgroup analyses of patients with Sunitinib as first-line therapy (PFS p < 0.001; OS: p < 0.001).Conclusion: Despite its rare occurrence, our findings confirm sRCC as a powerful predictor for inferior outcomes in mRCC treated with targeted therapies. This suggests a need for more tailored treatment strategies in patients harboring mRCC with sarcomatoid histology to improve oncological outcomes.Florian JanischFlorian JanischChristina KienapfelConstantin FühnerThomas KlotzbücherPhillip MarksTobias HillemacherChristian P. MeyerTakehiro IwataTakehiro IwataMehdi Kardoust PariziMehdi Kardoust PariziGuido SauterMargit FischShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatShahrokh F. ShariatRoland DahlemMichael RinkFrontiers Media S.A.articlerenal cell carcinomatyrosine kinase inhibitorstargeted therapysarcomatoid histologytherapy regimeSurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	renal cell carcinoma tyrosine kinase inhibitors targeted therapy sarcomatoid histology therapy regime Surgery RD1-811
spellingShingle	renal cell carcinoma tyrosine kinase inhibitors targeted therapy sarcomatoid histology therapy regime Surgery RD1-811 Florian Janisch Florian Janisch Christina Kienapfel Constantin Fühner Thomas Klotzbücher Phillip Marks Tobias Hillemacher Christian P. Meyer Takehiro Iwata Takehiro Iwata Mehdi Kardoust Parizi Mehdi Kardoust Parizi Guido Sauter Margit Fisch Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Roland Dahlem Michael Rink Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data
description	Background: Sarcomatoid differentiation/histology of renal cell carcinoma (sRCC) in patients with metastatic renal cell carcinoma (mRCC) is still underresearched in current therapy regimes. We aimed to evaluate the impact of sRCC on outcomes in patients with mRCC treated with tyrosine kinase inhibitors (TKIs).Methods: We collected complete data of 262 consecutive mRCC patients from our institutional database for this retrospective study. All patients were treated with TKIs within a single or multimodal treatment approach. All analyses were adjusted for the presence of sRCC. Descriptive statistics as well as uni- and multivariable outcome metrics, including progression-free (PFS) and overall survival (OS) as endpoints were performed.Results: Overall, 18 patients had sRCC (6.9%). Patients with sRCC had more often clear-cell histology (p = 0.047), a higher T-stage (p = 0.048), and underwent cytoreductive nephrectomy more frequently (p < 0.001). The most common first-line TKIs were Sunitinib (65.6%), Sorafenib (19.5%), and Pazopanib (10.3%), respectively. At a median follow-up of 32 months, patients with sRCC had significantly reduced PFS (p = 0.02) and OS (p = 0.01) compared to patients without sRCC. In multivariable analyses that adjusted for the effects of standard mRCC predictors, the sarcomatoid feature retained its independent association with inferior PFS (HR: 2.39; p = 0.007) and OS (HR: 2.37; p = 0.001). This association remained statistically significant in subgroup analyses of patients with Sunitinib as first-line therapy (PFS p < 0.001; OS: p < 0.001).Conclusion: Despite its rare occurrence, our findings confirm sRCC as a powerful predictor for inferior outcomes in mRCC treated with targeted therapies. This suggests a need for more tailored treatment strategies in patients harboring mRCC with sarcomatoid histology to improve oncological outcomes.
format	article
author	Florian Janisch Florian Janisch Christina Kienapfel Constantin Fühner Thomas Klotzbücher Phillip Marks Tobias Hillemacher Christian P. Meyer Takehiro Iwata Takehiro Iwata Mehdi Kardoust Parizi Mehdi Kardoust Parizi Guido Sauter Margit Fisch Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Roland Dahlem Michael Rink
author_facet	Florian Janisch Florian Janisch Christina Kienapfel Constantin Fühner Thomas Klotzbücher Phillip Marks Tobias Hillemacher Christian P. Meyer Takehiro Iwata Takehiro Iwata Mehdi Kardoust Parizi Mehdi Kardoust Parizi Guido Sauter Margit Fisch Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Shahrokh F. Shariat Roland Dahlem Michael Rink
author_sort	Florian Janisch
title	Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data
title_short	Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data
title_full	Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data
title_fullStr	Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data
title_full_unstemmed	Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data
title_sort	treatment and outcome of metastatic renal cell carcinoma with sarcomatoid differentiation: a single-center, real-world analysis of retrospective data
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/46f83ba3e8464463b86b544dabfebe2d
work_keys_str_mv	AT florianjanisch treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT florianjanisch treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT christinakienapfel treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT constantinfuhner treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT thomasklotzbucher treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT phillipmarks treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT tobiashillemacher treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT christianpmeyer treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT takehiroiwata treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT takehiroiwata treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT mehdikardoustparizi treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT mehdikardoustparizi treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT guidosauter treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT margitfisch treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT shahrokhfshariat treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT shahrokhfshariat treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT shahrokhfshariat treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT shahrokhfshariat treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT shahrokhfshariat treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT shahrokhfshariat treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT rolanddahlem treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata AT michaelrink treatmentandoutcomeofmetastaticrenalcellcarcinomawithsarcomatoiddifferentiationasinglecenterrealworldanalysisofretrospectivedata
_version_	1718424474933526528

Treatment and Outcome of Metastatic Renal Cell Carcinoma With Sarcomatoid Differentiation: A Single-Center, Real-World Analysis of Retrospective Data

Ejemplares similares