Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy

Derya Tilki, Brian Hu, Hao G. Nguyen, Marc A. Dall'Era, Roberto Bertini, Joaquín A. Carballido, Thenappan Chandrasekar, Thomas Chromecki, Gaetano Ciancio, Siamak Daneshmand, Paolo Gontero, Javier Gonzalez, Axel Haferkamp, Markus Hohenfellner, William C. Huang, Theresa Koppie, Estefania Linares, C. Adam Lorentz, Philipp Mandel, Juan I. Martinez-Salamanca & 22 others Viraj A. Master, Rayan Matloob, James M. McKiernan, Carrie M. Mlynarczyk, Francesco Montorsi, Giacomo Novara, Sascha Pahernik, Juan Palou, Raj S. Pruthi, Krishna Ramaswamy, Oscar Rodriguez Faba, Paul Russo, Shahrokh F. Shariat, Martin Spahn, Carlo Terrone, William Thieu, Daniel Vergho, Eric M. Wallen, Evanguelos Xylinas, Richard Zigeuner, John A. Libertino, Christopher P. Evans

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Purpose Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. Materials and Methods The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. Results Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. Conclusions In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.

Original languageEnglish (US)
Pages (from-to)436-442
Number of pages7
JournalJournal of Urology
Volume193
Issue number2
DOIs
StatePublished - Feb 1 2015

Fingerprint

Thrombectomy
Nephrectomy
Renal Cell Carcinoma
Neoplasm Metastasis
Survival
Neoplasms
Lymph Nodes
Thrombosis
Proportional Hazards Models
Histology

Keywords

  • carcinoma, renal cell
  • neoplasm metastasis
  • prognosis
  • survival
  • vena cava, inferior

ASJC Scopus subject areas

  • Urology
  • Medicine(all)

Cite this

Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy. / Tilki, Derya; Hu, Brian; Nguyen, Hao G.; Dall'Era, Marc A.; Bertini, Roberto; Carballido, Joaquín A.; Chandrasekar, Thenappan; Chromecki, Thomas; Ciancio, Gaetano; Daneshmand, Siamak; Gontero, Paolo; Gonzalez, Javier; Haferkamp, Axel; Hohenfellner, Markus; Huang, William C.; Koppie, Theresa; Linares, Estefania; Lorentz, C. Adam; Mandel, Philipp; Martinez-Salamanca, Juan I.; Master, Viraj A.; Matloob, Rayan; McKiernan, James M.; Mlynarczyk, Carrie M.; Montorsi, Francesco; Novara, Giacomo; Pahernik, Sascha; Palou, Juan; Pruthi, Raj S.; Ramaswamy, Krishna; Rodriguez Faba, Oscar; Russo, Paul; Shariat, Shahrokh F.; Spahn, Martin; Terrone, Carlo; Thieu, William; Vergho, Daniel; Wallen, Eric M.; Xylinas, Evanguelos; Zigeuner, Richard; Libertino, John A.; Evans, Christopher P.

In: Journal of Urology, Vol. 193, No. 2, 01.02.2015, p. 436-442.

Research output: Contribution to journalArticle

Tilki, D, Hu, B, Nguyen, HG, Dall'Era, MA, Bertini, R, Carballido, JA, Chandrasekar, T, Chromecki, T, Ciancio, G, Daneshmand, S, Gontero, P, Gonzalez, J, Haferkamp, A, Hohenfellner, M, Huang, WC, Koppie, T, Linares, E, Lorentz, CA, Mandel, P, Martinez-Salamanca, JI, Master, VA, Matloob, R, McKiernan, JM, Mlynarczyk, CM, Montorsi, F, Novara, G, Pahernik, S, Palou, J, Pruthi, RS, Ramaswamy, K, Rodriguez Faba, O, Russo, P, Shariat, SF, Spahn, M, Terrone, C, Thieu, W, Vergho, D, Wallen, EM, Xylinas, E, Zigeuner, R, Libertino, JA & Evans, CP 2015, 'Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy', Journal of Urology, vol. 193, no. 2, pp. 436-442. https://doi.org/10.1016/j.juro.2014.07.087
Tilki, Derya ; Hu, Brian ; Nguyen, Hao G. ; Dall'Era, Marc A. ; Bertini, Roberto ; Carballido, Joaquín A. ; Chandrasekar, Thenappan ; Chromecki, Thomas ; Ciancio, Gaetano ; Daneshmand, Siamak ; Gontero, Paolo ; Gonzalez, Javier ; Haferkamp, Axel ; Hohenfellner, Markus ; Huang, William C. ; Koppie, Theresa ; Linares, Estefania ; Lorentz, C. Adam ; Mandel, Philipp ; Martinez-Salamanca, Juan I. ; Master, Viraj A. ; Matloob, Rayan ; McKiernan, James M. ; Mlynarczyk, Carrie M. ; Montorsi, Francesco ; Novara, Giacomo ; Pahernik, Sascha ; Palou, Juan ; Pruthi, Raj S. ; Ramaswamy, Krishna ; Rodriguez Faba, Oscar ; Russo, Paul ; Shariat, Shahrokh F. ; Spahn, Martin ; Terrone, Carlo ; Thieu, William ; Vergho, Daniel ; Wallen, Eric M. ; Xylinas, Evanguelos ; Zigeuner, Richard ; Libertino, John A. ; Evans, Christopher P. / Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy. In: Journal of Urology. 2015 ; Vol. 193, No. 2. pp. 436-442.
@article{dd91e540f35b4641bf4bc036971bcccf,
title = "Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy",
abstract = "Purpose Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. Materials and Methods The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. Results Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44{\%}) patients. Of the patients with distant disease 385 (53{\%}) had an isolated metastasis. The 5-year cancer specific survival was 51.3{\%} (95{\%} CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. Conclusions In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.",
keywords = "carcinoma, renal cell, neoplasm metastasis, prognosis, survival, vena cava, inferior",
author = "Derya Tilki and Brian Hu and Nguyen, {Hao G.} and Dall'Era, {Marc A.} and Roberto Bertini and Carballido, {Joaqu{\'i}n A.} and Thenappan Chandrasekar and Thomas Chromecki and Gaetano Ciancio and Siamak Daneshmand and Paolo Gontero and Javier Gonzalez and Axel Haferkamp and Markus Hohenfellner and Huang, {William C.} and Theresa Koppie and Estefania Linares and Lorentz, {C. Adam} and Philipp Mandel and Martinez-Salamanca, {Juan I.} and Master, {Viraj A.} and Rayan Matloob and McKiernan, {James M.} and Mlynarczyk, {Carrie M.} and Francesco Montorsi and Giacomo Novara and Sascha Pahernik and Juan Palou and Pruthi, {Raj S.} and Krishna Ramaswamy and {Rodriguez Faba}, Oscar and Paul Russo and Shariat, {Shahrokh F.} and Martin Spahn and Carlo Terrone and William Thieu and Daniel Vergho and Wallen, {Eric M.} and Evanguelos Xylinas and Richard Zigeuner and Libertino, {John A.} and Evans, {Christopher P.}",
year = "2015",
month = "2",
day = "1",
doi = "10.1016/j.juro.2014.07.087",
language = "English (US)",
volume = "193",
pages = "436--442",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "2",

}

TY - JOUR

T1 - Impact of synchronous metastasis distribution on cancer specific survival in renal cell carcinoma after radical nephrectomy with tumor thrombectomy

AU - Tilki, Derya

AU - Hu, Brian

AU - Nguyen, Hao G.

AU - Dall'Era, Marc A.

AU - Bertini, Roberto

AU - Carballido, Joaquín A.

AU - Chandrasekar, Thenappan

AU - Chromecki, Thomas

AU - Ciancio, Gaetano

AU - Daneshmand, Siamak

AU - Gontero, Paolo

AU - Gonzalez, Javier

AU - Haferkamp, Axel

AU - Hohenfellner, Markus

AU - Huang, William C.

AU - Koppie, Theresa

AU - Linares, Estefania

AU - Lorentz, C. Adam

AU - Mandel, Philipp

AU - Martinez-Salamanca, Juan I.

AU - Master, Viraj A.

AU - Matloob, Rayan

AU - McKiernan, James M.

AU - Mlynarczyk, Carrie M.

AU - Montorsi, Francesco

AU - Novara, Giacomo

AU - Pahernik, Sascha

AU - Palou, Juan

AU - Pruthi, Raj S.

AU - Ramaswamy, Krishna

AU - Rodriguez Faba, Oscar

AU - Russo, Paul

AU - Shariat, Shahrokh F.

AU - Spahn, Martin

AU - Terrone, Carlo

AU - Thieu, William

AU - Vergho, Daniel

AU - Wallen, Eric M.

AU - Xylinas, Evanguelos

AU - Zigeuner, Richard

AU - Libertino, John A.

AU - Evans, Christopher P.

PY - 2015/2/1

Y1 - 2015/2/1

N2 - Purpose Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. Materials and Methods The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. Results Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. Conclusions In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.

AB - Purpose Metastatic renal cell carcinoma can be clinically diverse in terms of the pattern of metastatic disease and response to treatment. We studied the impact of metastasis and location on cancer specific survival. Materials and Methods The records of 2,017 patients with renal cell cancer and tumor thrombus who underwent radical nephrectomy and tumor thrombectomy from 1971 to 2012 at 22 centers in the United States and Europe were analyzed. Number and location of synchronous metastases were compared with respect to patient cancer specific survival. Multivariable Cox regression models were used to quantify the impact of covariates. Results Lymph node metastasis (155) or distant metastasis (725) was present in 880 (44%) patients. Of the patients with distant disease 385 (53%) had an isolated metastasis. The 5-year cancer specific survival was 51.3% (95% CI 48.6-53.9) for the entire group. On univariable analysis patients with isolated lymph node metastasis had a significantly worse cancer specific survival than those with a solitary distant metastasis. The location of distant metastasis did not have any significant effect on cancer specific survival. On multivariable analysis the presence of lymph node metastasis, isolated distant metastasis and multiple distant metastases were independently associated with cancer specific survival. Moreover higher tumor thrombus level, papillary histology and the use of postoperative systemic therapy were independently associated with worse cancer specific survival. Conclusions In our multi-institutional series of patients with renal cell cancer who underwent radical nephrectomy and tumor thrombectomy, almost half of the patients had synchronous lymph node or distant organ metastasis. Survival was superior in patients with solitary distant metastasis compared to isolated lymph node disease.

KW - carcinoma, renal cell

KW - neoplasm metastasis

KW - prognosis

KW - survival

KW - vena cava, inferior

UR - http://www.scopus.com/inward/record.url?scp=84920715458&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84920715458&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2014.07.087

DO - 10.1016/j.juro.2014.07.087

M3 - Article

VL - 193

SP - 436

EP - 442

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 2

ER -