Kategorie: Genitourinární nádory
Téma: XXIII. Uroonkologie
Číslo abstraktu: XXIII/ 102
Autoři: MUDr. Kateřina Kubáčková; prof. MUDr. Bohuslav Melichar, Ph.D.; Mgr. Zbyněk Bortlíček; MUDr. Alexandr Poprach, Ph.D.; Doc. MUDr. Tomáš Büchler, Ph.D.; MUDr. Radek Lakomý, Ph.D.; prof. MUDr. Rostislav Vyzula, CSc.; Prof. RNDr. Ladislav Dušek, Ph.D.; prof. MUDr. Marek Svoboda, Ph.D.; Doc. MUDr. Jana Prausová, Ph.D., MBA
The aim of our study was to compare two different prognostic factors models in terms of progression-free survival (PFS), median overall survival (OS) and 1-year survival in a patient population treated first-line with sunitinib for metastatic renal cell carcinoma (mRCC).
Material and Methods:
Data from the Czech Patient Registry RENIS (RENal Information System, http:/ / renis.registry.cz) were analysed retrospectively. Only those patients who met prognostic model criteria for recording of baseline parameters and outcomes data were included in the analysis (n = 495). The performance of the modified Memorial Sloan Kettering Cancer Center (MSKCC) model and the International mRCC Database Consortium (IDC) model was compared. PFS and OS were estimated using the Kaplan-Meier method. The statistical significance of differences in Kaplan-Meier estimates was assessed using the log-rank test.
Median OS for prognostic groups according to MSKCC criteria and IDC criteria, respectively, was 39.5 months (95% CI: 23.9–55.2) vs. 44.3 months (95% CI: 31.7–56.9) for favourable-risk (no adverse factors) patients, 28.5 months (95% CI: 20.1–36.8) vs. 24.8 months (95% CI: 19.4–30.3) for intermediate-risk (one or two adverse factors) patients, and 10.6 months (95% CI: 6.3–14.8) vs. 8.1 months (95% CI: 4.3–11.8) for poor-risk (three or more adverse factors) patients. The majority of MSKCC poor-risk patients (62.4%, n = 83) were reclassified as intermediate-risk using IDC criteria, and 23.2% (n = 70) of MSKCC intermediate-risk patients were reclassified to the IDC favourable-risk group.
Both MSKCC and IDC models were validated in our cohort. Use of the IDC model resulted in an upward shift in prognostic assessment compared to the MSKCC model. This may have implications on patient selection for targeted therapy. The results of our analysis support incorporation of the IDC model into the clinical decision-making process.
Datum přednesení příspěvku: 9. 4. 2015