Regarding different sites of BMs, patients with metastases localized to long bones were characterized by a better prognosis. On the other hand, no significant difference was found between synchronous and metachronous BMs. Moreover, surprisingly compared with other series,3,4 presence of concomitant liver metastases was not an independent prognostic factor. However, the most interesting result concerns the patients presenting with a solitary lesion at the initial diagnosis of RCC (SSBM). In our study, we found that they were characterized by a better prognosis. Improved survival in this group of patients may have different explanations but the opportunity to perform a radical resection seems to have the greatest impact. Indeed, the large majority of patients with a SSBM underwent bone surgery (76%). Moreover, regarding BMs’ therapy, radical resection was correlated with longer survival, while palliative surgery, radiotherapy and the other local and systemic treatments were not significantly associated with OS.
This data is even more interesting if we consider that studies on management of solitary BMs are limited and there are no standard recommendations on the best treatment modality to use in this group of patients. Based on these findings, radical surgery needs to be performed in patients with single BM to achieve local tumor control, to delay the systemic treatments and to improve survival.
Written by: Fiorella Ruatta, MD, Division of Medical Oncology, Institute for Cancer Research and Treatment, Torino, Italy, and Lisa Derosa, MD, Ph.D., Department of Cancer Medicine, Gustave Roussy Cancer Campus, Paris-Sud University, Villejuif, France.
References:
1. Kalra S, Verma J, Atkinson BJ, et al. Outcomes of Patients With Metastatic Renal Cell Carcinoma and Bone Metastases in the Targeted Therapy Era. Clin Genitourin Cancer. 2017;18(17):30010-30011.
2. Santini D, Procopio G, Porta C, et al. Natural history of malignant bone disease in renal cancer: final results of an Italian bone metastasis survey. PLoS One. 2013;8(12):e83026.
3. Santoni M, Santini D, Massari F, et al. Heterogeneous drug target expression as possible basis for different clinical and radiological response to the treatment of primary and metastatic renal cell carcinoma: suggestions from bench to bedside. Cancer Metastasis Rev. 2014;33(1):321-331.
4. Grassi P, Verzoni E, Porcu L, et al. Targeted therapies in advanced renal cell carcinoma: the role of metastatic sites as a prognostic factor. Future Oncol. 2014;10(8):1361-1372.
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This data is even more interesting if we consider that studies on management of solitary BMs are limited and there are no standard recommendations on the best treatment modality to use in this group of patients. Based on these findings, radical surgery needs to be performed in patients with single BM to achieve local tumor control, to delay the systemic treatments and to improve survival.
Written by: Fiorella Ruatta, MD, Division of Medical Oncology, Institute for Cancer Research and Treatment, Torino, Italy, and Lisa Derosa, MD, Ph.D., Department of Cancer Medicine, Gustave Roussy Cancer Campus, Paris-Sud University, Villejuif, France.
References:
1. Kalra S, Verma J, Atkinson BJ, et al. Outcomes of Patients With Metastatic Renal Cell Carcinoma and Bone Metastases in the Targeted Therapy Era. Clin Genitourin Cancer. 2017;18(17):30010-30011.
2. Santini D, Procopio G, Porta C, et al. Natural history of malignant bone disease in renal cancer: final results of an Italian bone metastasis survey. PLoS One. 2013;8(12):e83026.
3. Santoni M, Santini D, Massari F, et al. Heterogeneous drug target expression as possible basis for different clinical and radiological response to the treatment of primary and metastatic renal cell carcinoma: suggestions from bench to bedside. Cancer Metastasis Rev. 2014;33(1):321-331.
4. Grassi P, Verzoni E, Porcu L, et al. Targeted therapies in advanced renal cell carcinoma: the role of metastatic sites as a prognostic factor. Future Oncol. 2014;10(8):1361-1372.
Read the Abstract