To evaluate population-based survival trends, compared to optimistic trial benchmarks, in metastatic renal cell carcinoma (mRCC). Advances in medical therapy for mRCC may be associated with survival improvements.
Yet, targeted therapy trial results focus on patients with favorable-risk mRCC and may not be well disseminated at the population level.
Surveillance, Epidemiology, and End Results identified adult mRCC patients diagnosed between 1990 and 2009. Survival was analyzed by treatment era (cytokine, 1990-2005; targeted therapy, 2006-2009) and stratified by histology. Multivariate Cox regression identified factors independently associated with overall survival.
We identified 14,521 eligible patients. For clear cell mRCC (N = 4149), median survival improved from 11 to 14 months before and after targeted therapy (P
Population-based mRCC median survival improved but to a lesser degree than that reported in clinical trials. This represents opportunity for quality improvement in histologically guided care, use of cytoreductive nephrectomy, and development of strategies for trial-ineligible, poor-risk patients.
Urology. 2015 Jul 18 [Epub]
Liam C Macleod, Scott S Tykodi, Sarah K Holt, Jonathan L Wright, Daniel W Lin, Maria S Tretiakova, Lawrence D True, John L Gore
Department of Urology, University of Washington, Seattle, WA. Division of Medical Oncology, Department of Medicine, University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA. , Department of Urology, University of Washington, Seattle, WA. , Department of Urology, University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA. , Department of Urology, University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA. , Department of Pathology, University of Washington, Seattle, WA. , Department of Pathology, University of Washington, Seattle, WA. , Department of Urology, University of Washington, Seattle, WA; Fred Hutchinson Cancer Research Center, Seattle, WA.