title: Duration of First-line Treatment with Molecular Targeted-Therapy Is a Prognostic Factor in Metastatic Renal Cell Carcinoma.
abstract: OBJECTIVE
  We investigated the prognostic factors associated with overall survival (OS) in patients with metastatic renal cell carcinoma (mRCC) who received molecular targeted-therapies.
  
  
  METHODS
  A total of 66 patients underwent molecular targeted-therapies at the Kurume University between May 2008 and April 2014. Medical records were retrieved and analyzed retrospectively.
  
  
  RESULTS
  The median OS was 25.9 [95% confidence interval (CI)=18.3-33.7] months. The median OS stratified by the Memorial Sloan Kettering Cancer Center risk classification was 49.3, 28.6 and 18.3 months for the favorable-, intermediate- and poor-risk groups, respectively. Univariate analyses for various factors revealed gender, pre-treatment C-reactive protein (CRP) level, best response to first-line treatment, the number of molecular targeted agents and the duration of first-line treatment with a median of 6 months, as prognostic variables. Multivariate analyses showed than two or more than three molecular targeted agents [two: hazard ratio (HR)=0.351, 95% CI=0.121-0.901; more than three: HR=0.193, 95% CI=0.069-0.495] and a duration of first-line treatment of more than 6 months (HR=0.203, 95% CI=0.078-0.498) to be independent prognostic factors.
  
  
  CONCLUSIONS
  Our results suggest that the duration of first-line treatment with molecular targeted-therapies is the strongest prognostic factor in patients with mRCC.
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan ueda_kousuke@med.kurume-u.ac.jp.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Ueda
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Suekane
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Kiyoaki
authors.initials: K
authors.lastname: Nishihara
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Naoyuki
authors.initials: N
authors.lastname: Ogasawara
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Kurose
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Hayashi
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Katsuaki
authors.initials: K
authors.lastname: Chikui
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Shunsuke
authors.initials: S
authors.lastname: Suyama
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakiri
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Matsuo
authors.affiliation: Department of Urology, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Igawa
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000235:genetics; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D011379:Prognosis; D016896:Treatment Outcome
chemical_list: D002097:C-Reactive Protein
keywords: Renal cell carcinoma; duration of first-line treatment; molecular targeted therapy; prognostic factor