Therapy decision for patients with metastatic renal cell carcinoma (mRCC) is highly dependent on disease monitoring based on radiological reports. The purpose of the study was to compare non-standardized, common practice free text reporting (FTR) on disease response with reporting based on response evaluation criteria in solid tumors modified for immune-based therapeutics (iRECIST).
Fifty patients with advanced mRCC were included in the retrospective, single-center study. CT scans had been evaluated and FTR prepared in accordance with center's routine practice. For study purposes, reports were re-evaluated using a dedicated computer program that applied iRECIST. Patients were followed up over a period of 22.8 ± 7.9 months in intervals of 2.7 ± 1.8 months. Weighted kappa statistics was run to assess strength of agreement. Logistic regression was used to identify predictors for different rating.
Agreement between FTR and iRECIST-based reporting was moderate (kappa 0.38 [95% CI 0.2-0.6] to 0.70 [95% CI 0.5-0.9]). Tumor response or progression according to FTR were not confirmed with iRECIST in 19 (38%) or 11 (22%) patients, respectively, in at least one follow-up examination. With FTR, new lesions were frequently not recognized if they were already identified in the recent prior follow-up examination (odds ratio for too favorable rating of disease response compared to iRECIST: 5.4 [95% CI 2.9-10.1].
Moderate agreement between disease response according to FTR or iRECIST in patients with mRCC suggests the need of standardized quantitative radiological assessment in daily clinical practice.
Journal of cancer research and clinical oncology. 2022 Apr 14 [Epub ahead of print]
Laura Schomburg, Amer Malouhi, Marc-Oliver Grimm, Maja Ingwersen, Susan Foller, Katharina Leucht, Ulf Teichgräber
Department of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany., Department of Urology, Friedrich-Schiller-University, University Hospital Jena, Am Klinikum 1, 07743, Jena, Germany., Department of Diagnostic and Interventional Radiology, Friedrich-Schiller-University, University Hospital Jena, Am Klinikum 1, 07747, Jena, Germany. .