Abstract
BACKGROUND. The management of renal cell carcinoma (RCC) is evolving toward less extirpative surgery and the use of targeted therapy. The authors set out to provide a benchmark against which emerging therapies should be measured. METHODS. A prospective database including clinical and pathological variables for 1632 patients with RCC treated between 1989 and 2005 was queried. Patients were stratified using the University of California-Los Angeles Integrated Staging System (UISS) into low-, intermediate-, and high-risk groups. Disease-specific survival (DSS) was measured. Response to systemic therapy for patients with advanced disease was assessed. RESULTS. Nephrectomy was performed in 1492 patients. Overall 5-, 10-, and 15-year DSS was 55%, 40%, and 29%. For localized disease, 5- and 10-year DSS for UISS low-, intermediate-, and high-risk groups was 97% and 92%, 81% and 61%, and 62% and 41%, respectively. For metastatic disease, 5- and 10-year DSS for UISS low-, intermediate-, and high-risk groups was 41% and 31%, 18% and 7%, and 8% and 0%, respectively. Patients with metastatic disease receiving immunotherapy (n = 453) had complete response in 7% (median survival [MS], 1201 months), partial response in 15% (MS, 42.8 months), stable disease in 33% (MS, 38.6 months), and progressive disease in 45% (MS, 11.6 months). CONCLUSIONS. Most patients with localized RCC do well with surgery alone, but effective adjuvant therapy is needed for patients identified as at high risk for recurrence. For advanced disease, newer targeted and potentially less toxic treatments should be at least as effective as those achieved with aggressive surgical resection and immunotherapy.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 2457-2463 |
| Number of pages | 7 |
| Journal | Cancer |
| Volume | 113 |
| Issue number | 9 |
| DOIs | |
| State | Published - Nov 1 2008 |
| Externally published | Yes |
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Keywords
- Immunotherapy
- Interleukin-2
- Kidney cancer
- Survival
ASJC Scopus subject areas
- Cancer Research
- Oncology
Cite this
Cancer-specific survival outcomes among patients treated during the cytokine era of kidney cancer (1989-2005) : A benchmark for emerging targeted cancer therapies. / Belldegrun, Arie S.; Klatte, Tobias; Shuch, Brian; LaRochelle, Jeffrey C.; Miller, David C.; Said, Jonathan W.; Riggs, Stephen B.; Zomorodian, Nazy; Kabbinavar, Fairooz F.; DeKernion, Jean B.; Pantuck, Allan J.
In: Cancer, Vol. 113, No. 9, 01.11.2008, p. 2457-2463.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Cancer-specific survival outcomes among patients treated during the cytokine era of kidney cancer (1989-2005)
T2 - A benchmark for emerging targeted cancer therapies
AU - Belldegrun, Arie S.
AU - Klatte, Tobias
AU - Shuch, Brian
AU - LaRochelle, Jeffrey C.
AU - Miller, David C.
AU - Said, Jonathan W.
AU - Riggs, Stephen B.
AU - Zomorodian, Nazy
AU - Kabbinavar, Fairooz F.
AU - DeKernion, Jean B.
AU - Pantuck, Allan J.
PY - 2008/11/1
Y1 - 2008/11/1
N2 - BACKGROUND. The management of renal cell carcinoma (RCC) is evolving toward less extirpative surgery and the use of targeted therapy. The authors set out to provide a benchmark against which emerging therapies should be measured. METHODS. A prospective database including clinical and pathological variables for 1632 patients with RCC treated between 1989 and 2005 was queried. Patients were stratified using the University of California-Los Angeles Integrated Staging System (UISS) into low-, intermediate-, and high-risk groups. Disease-specific survival (DSS) was measured. Response to systemic therapy for patients with advanced disease was assessed. RESULTS. Nephrectomy was performed in 1492 patients. Overall 5-, 10-, and 15-year DSS was 55%, 40%, and 29%. For localized disease, 5- and 10-year DSS for UISS low-, intermediate-, and high-risk groups was 97% and 92%, 81% and 61%, and 62% and 41%, respectively. For metastatic disease, 5- and 10-year DSS for UISS low-, intermediate-, and high-risk groups was 41% and 31%, 18% and 7%, and 8% and 0%, respectively. Patients with metastatic disease receiving immunotherapy (n = 453) had complete response in 7% (median survival [MS], 1201 months), partial response in 15% (MS, 42.8 months), stable disease in 33% (MS, 38.6 months), and progressive disease in 45% (MS, 11.6 months). CONCLUSIONS. Most patients with localized RCC do well with surgery alone, but effective adjuvant therapy is needed for patients identified as at high risk for recurrence. For advanced disease, newer targeted and potentially less toxic treatments should be at least as effective as those achieved with aggressive surgical resection and immunotherapy.
AB - BACKGROUND. The management of renal cell carcinoma (RCC) is evolving toward less extirpative surgery and the use of targeted therapy. The authors set out to provide a benchmark against which emerging therapies should be measured. METHODS. A prospective database including clinical and pathological variables for 1632 patients with RCC treated between 1989 and 2005 was queried. Patients were stratified using the University of California-Los Angeles Integrated Staging System (UISS) into low-, intermediate-, and high-risk groups. Disease-specific survival (DSS) was measured. Response to systemic therapy for patients with advanced disease was assessed. RESULTS. Nephrectomy was performed in 1492 patients. Overall 5-, 10-, and 15-year DSS was 55%, 40%, and 29%. For localized disease, 5- and 10-year DSS for UISS low-, intermediate-, and high-risk groups was 97% and 92%, 81% and 61%, and 62% and 41%, respectively. For metastatic disease, 5- and 10-year DSS for UISS low-, intermediate-, and high-risk groups was 41% and 31%, 18% and 7%, and 8% and 0%, respectively. Patients with metastatic disease receiving immunotherapy (n = 453) had complete response in 7% (median survival [MS], 1201 months), partial response in 15% (MS, 42.8 months), stable disease in 33% (MS, 38.6 months), and progressive disease in 45% (MS, 11.6 months). CONCLUSIONS. Most patients with localized RCC do well with surgery alone, but effective adjuvant therapy is needed for patients identified as at high risk for recurrence. For advanced disease, newer targeted and potentially less toxic treatments should be at least as effective as those achieved with aggressive surgical resection and immunotherapy.
KW - Immunotherapy
KW - Interleukin-2
KW - Kidney cancer
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=55549134997&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=55549134997&partnerID=8YFLogxK
U2 - 10.1002/cncr.23851
DO - 10.1002/cncr.23851
M3 - Article
C2 - 18823034
AN - SCOPUS:55549134997
VL - 113
SP - 2457
EP - 2463
JO - Cancer
JF - Cancer
SN - 0008-543X
IS - 9
ER -