title: Effect of reclassification of the IMDC model in patients with metastatic renal cell carcinoma treated with targeted therapy in the first-line and second-line settings.
abstract: To investigate the prognostic effect of the International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) model reclassification after targeted therapy administration in metastatic renal cell carcinoma (mRCC).
  
  
  
  A total of 245 mRCC patients treated with targeted therapy are included. The IMDC model reclassification is performed at 1 month after treatment induction of both first-line and second-line targeted therapy.
  
  
  
  Of the 245 patients, 74 (30.2%) are divided into different risk groups by the IMDC model reclassification after first-line targeted therapy, and patients newly classified with intermediate risk tend to have better overall survival than those remaining in the primary poor-risk group (P = 0.018). Of the 119 patients treated with subsequent second-line targeted therapy, 25 (21.0%) are divided into different risk groups by the IMDC model reclassification after second-line targeted therapy, and patients newly classified with poor risk tend to have increased all-cause mortality compared with those remaining in the primary intermediate-risk group (P = 0.007), whereas patients newly classified with intermediate risk tend to have better overall survival than those remaining in the primary poor-risk group (P = 0.034).
  
  
  
  Approximately a quarter of the mRCC patients are classified into different risk groups of the IMDC model following targeted therapy administration in the first-line and second-line settings. There is a significant difference in overall survival of subgroups after the IMDC model reclassifications.
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan; Department of Urology, Saitama City Hospital, Saitama, Japan. Electronic address: urotanaka@gmail.com.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Tanaka
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan. Electronic address: mizunor@z7.keio.jp.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Mizuno
authors.affiliation: Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Suguru
authors.initials: S
authors.lastname: Shirotake
authors.affiliation: Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Keiichi
authors.initials: K
authors.lastname: Ito
authors.affiliation: Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Yota
authors.initials: Y
authors.lastname: Yasumizu
authors.affiliation: Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Ayako
authors.initials: A
authors.lastname: Masunaga
authors.affiliation: Department of Urology, Saiseikai Central Hospital, Tokyo, Japan.
authors.forename: Yujiro
authors.initials: Y
authors.lastname: Ito
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Yasumasa
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Department of Urology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Chiba, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Hagiwara
authors.affiliation: Department of Urology, Aichi Medical University School of Medicine, Nagakute, Aichi, Japan.
authors.forename: Kent
authors.initials: K
authors.lastname: Kanao
authors.affiliation: Division of Diagnostic Pathology, Keio University Hospital, Tokyo, Japan.
authors.forename: Shuji
authors.initials: S
authors.lastname: Mikami
authors.affiliation: Department of Urology, Ichikawa General Hospital, Tokyo Dental College, Ichikawa, Chiba, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Nakagawa
authors.affiliation: Department of Urology, National Hospital Organization Saitama Hospital, Wako, Saitama, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Momma
authors.affiliation: Department of Urology, Saitama City Hospital, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Masuda
authors.affiliation: Department of Urology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Tomohiko
authors.initials: T
authors.lastname: Asano
authors.affiliation: Department of Uro-Oncology, Saitama Medical University International Medical Center, Hidaka, Japan.
authors.forename: Masafumi
authors.initials: M
authors.lastname: Oyama
authors.affiliation: Department of Urology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Mototsugu
authors.initials: M
authors.lastname: Oya
mesh_terms: D000368:Aged; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: IMDC; Metastasis; Outcome; Prognosis; Reclassification; Renal cell carcinoma; Targeted therapy