title: Nasal metastases from renal cell carcinoma are associated with Memorial Sloan-Kettering Cancer Center poor-prognosis classification.
abstract: Unusual sites of metastases are recognized in patients with renal cell carcinoma (RCC). However, the prognostic implications of these sites are not well understood. We used the Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification for metastatic RCC to evaluate 912 consecutive patients with RCC managed at the Singapore General Hospital between 1990 and 2009. Among these patients, 301 had metastases either at diagnosis or during the course of illness. Nasal metastases, all arising from clear cell RCC, were identified histologically in 4 patients (1.3% of those with metastasis). All 4 patients were classified as MSKCC poor prognosis by current risk criteria. Nasal metastases were significantly associated with lung and bone metastases. The frequency of nasal metastases in patients with metastatic RCC is about 1%, occurring predominantly in patients with clear cell RCC. Nasal metastases are associated with poor prognosis as estimated by the MSKCC risk classification, with attendant implications for selection of targeted therapy, and are usually associated with multi-organ dissemination, including concurrent lung and bone involvement.
authors.affiliation: Department of Medical Oncology, National Cancer Centre, Singapore, Singapore 169610, Republic of Singapore.
authors.forename: Caroline Victoria
authors.initials: CV
authors.lastname: Choong
authors.forename: Tiffany
authors.initials: T
authors.lastname: Tang
authors.forename: Wen Yee
authors.initials: WY
authors.lastname: Chay
authors.forename: Christopher
authors.initials: C
authors.lastname: Goh
authors.forename: Miah Hiang
authors.initials: MH
authors.lastname: Tay
authors.forename: Nor Azhari Mohd
authors.initials: NA
authors.lastname: Zam
authors.forename: Puay Hoon
authors.initials: PH
authors.lastname: Tan
authors.forename: Min-Han
authors.initials: MH
authors.lastname: Tan
mesh_terms: D000970:Antineoplastic Agents / Q000627:therapeutic use; D001859:Bone Neoplasms / Q000556:secondary; D002292:Carcinoma, Renal Cell / Q000000981:diagnostic imaging / Q000556:secondary* / Q000628:therapy; D005260:Female; D006801:Humans; D007211:Indoles / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology* / Q000628:therapy; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D009669:Nose Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D011758:Pyrroles / Q000627:therapeutic use; D012888:Skull Neoplasms / Q000000981:diagnostic imaging / Q000556:secondary; D000077210:Sunitinib; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D000077210:Sunitinib