title: Sequential therapy and prognostic factors in metastatic renal cell carcinoma: single centre experience.
abstract: OBJECTIVE
  In advanced stage renal cell cancer (RCC), overall survival (OS) of patients has been prolonged due to targeted therapies. To date, there are several prognostic risk models that have been developed for metastatic RCC (mRCC). The purpose of this study was to evaluate the outcomes of the sequential therapy (IFN-α, tyrosine kinase inhibitors/TKIs, m-TOR inhibitor) and prognostic factors in patients with mRCC, especially those with bone metastasis.
  
  
  METHODS
  We retrospectively examined the data of 82 patients with pathologically proven mRCC who were followed-up and treated at the Medical Oncology Clinic of the Dr A.Y Oncology Hospital between 2005 and 2013.
  
  
  RESULTS
  Median OS was 23 months in all patients with mRCC and 20 months in patients treated with TKIs. According to MSKCC and HENG risk classifications, median OS differed between the groups (p=0.02, p<0.001, respectively). Median OS was lower in patients with isolated bone metastasis compared to those with lung metastasis (16 vs 24 months, p=0.25). Median OS improved with increasing number of sequential therapies (p=0.08).
  
  
  CONCLUSIONS
  This study confirmed the correlation between MSKCC and HENG risk models and survival data. Additionally, it was shown that increase of the number of therapeutic lines in sequential therapy prolonged survival and that bone metastases were negative prognostic factors.
authors.affiliation: Ankara Oncology Education and Research Hospital, Medical Oncology Clinic, Ankara, Turkey.
authors.forename: Onur
authors.initials: O
authors.lastname: Esbah
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Kaan
authors.initials: K
authors.lastname: Helvaci
authors.forename: Fatma
authors.initials: F
authors.lastname: Paksoy Turkoz
authors.forename: Ahmet
authors.initials: A
authors.lastname: Siyar Ekinci
authors.forename: Ozlem
authors.initials: O
authors.lastname: Uysal Sonmez
authors.forename: Umugul
authors.initials: U
authors.lastname: Uyeturk
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Turker
authors.forename: Tahsin
authors.initials: T
authors.lastname: Ozatli
authors.forename: Berna
authors.initials: B
authors.lastname: Oksuzoglu
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000628:therapy; D006801:Humans; D016898:Interferon-alpha; D007680:Kidney Neoplasms / Q000473:pathology* / Q000628:therapy; D058990:Molecular Targeted Therapy; D011379:Prognosis
chemical_list: D016898:Interferon-alpha