title: Characteristics of metastasis as a prognostic factor for immunotherapy in metastatic renal cell carcinoma.
abstract: OBJECTIVE
  This study aimed to evaluate the significance of characteristics of metastasis as prognostic factors in metastatic renal cell carcinoma (RCC).
  
  
  METHODS
  A total of 148 patients who had received immunotherapy were included in the study. Patients were categorized in various ways according to the characteristics of metastasis, including a synchronous metastasis group (n = 77) vs a metachronous metastasis group (n = 71), and a solitary metastasis group (n = 93) vs a multiple metastases group (n = 55).
  
  
  RESULTS
  In the synchronous and metachronous metastasis groups, median progression-free survival was 4.3 months (95% confidence interval [CI] 2.9-5.7) and 11.1 months (95% CI 6.7-15.5), respectively (P = 0.004). Median overall survival was 17.1 months (95% CI 9.5-24.7) and 54.8 months (95% Cl 38.371.3) in the two groups (P = 0.019). In the solitary and multiple metastasis groups, median progression-free survival was 11.0 months (95% CI 6.6-15.5) and 3.9 months (95% CI 2.6-5.2), respectively (P <0.001). Median overall survival was 55.2 months (95% CI 50.7-59.7) and 15.6 months (95% CI 10.9-20.3) in the two groups (P <0.001). Multivariate Cox proportional hazards model analysis using the clinical variables showed that T stage (P = 0.026), number of metastatic sites (P = 0.009) and time to metastasis (P = 0.019) were independent predictors of progression-free survival. Using the same variables, only the number of metastatic sites was an independent prognostic predictor of overall survival (P = 0.014).
  
  
  CONCLUSIONS
  Our findings suggest that the time to metastasis and the number of metastases are important prognostic factors in metastatic RCC.
authors: Department of Urology, Seoul National University College of Medicine, Korea.
authors: Cheol
authors: C
authors: Kwak
authors: Yong Hyun
authors: YH
authors: Park
authors: Chang Wook
authors: CW
authors: Jeong
authors: Hyeon
authors: H
authors: Jeong
authors: Sang Eun
authors: SE
authors: Lee
authors: Ja Hyeon
authors: JH
authors: Ku
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D005472:Fluorouracil / Q000627:therapeutic use; D006801:Humans; D007167:Immunotherapy; D016898:Interferon-alpha / Q000627:therapeutic use; D007376:Interleukin-2 / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis
chemical_list: D016898:Interferon-alpha; D007376:Interleukin-2; D005472:Fluorouracil