title: Prognosis of metastatic renal cell carcinoma with first-line interferon-α therapy in the era of molecular-targeted therapy.
abstract: The RCC-SELECT study showed the correlation between single nucleotide polymorphisms (SNP) in STAT3 gene and survival in metastatic renal cell carcinoma (mRCC) patients with first-line interferon-α (IFN-α). In that study, even patients with STAT3 SNP linked to shorter overall survival (OS) exhibited remarkably improved prognosis. All 180 patients evaluated in the above study were further analyzed for correlation between OS and demographics/clinicopathological parameters. OS was estimated using the Kaplan-Meier method. Associations between OS and potential prognostic factors were assessed using the log-rank test and the Cox proportional hazards model. The median OS was 42.8 months. Univariate analysis showed that worse Eastern Cooperative Oncology Group-performance status (ECOG-PS), high T stage, regional lymph node metastasis, distant metastasis, higher grade, infiltrative growth pattern, the presence of microscopic vascular invasion (MVI), hypercalcemia, anemia, thrombocytopenia and elevated C-reactive protein were significantly associated with OS. Multivariate analysis revealed that ECOG-PS (hazard ratio [HR] = 3.665, P = 0.0004), hypercalcemia (HR = 6.428, P = 0.0005) and the presence of MVI (HR = 2.668, P = 0.0109) were jointly significant poor prognostic factors. This is the first study analysing prognostic factors of mRCC patients with first-line IFN-α using large cohort of the prospective study. The present study suggests that first-line IFN-α is still a useful therapy for mRCC even in the era of molecular targeted therapy.
authors.affiliation: Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Kawano
authors.affiliation: Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Takahashi
authors.affiliation: Department of Urology, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan.|Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Eto
authors.affiliation: Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kamba
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Miyake
authors.affiliation: Division of Urology, Department of Surgery Related, Kobe University Graduate School of Medicine, Kobe, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Fujisawa
authors.affiliation: Department of Urology, Dokkyo Medical University, Shimotsuka- gun, Tochigi, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Kamai
authors.affiliation: Department of Urology, Kinki University School of Medicine, Osaka-Sayama, Japan.
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uemura
authors.affiliation: Department of Urologic Surgery and Andrology, Sapporo Medical University School of Medicine, Sapporo, Japan.
authors.forename: Taiji
authors.initials: T
authors.lastname: Tsukamoto
authors.affiliation: Department of Urology, Osaka Medical College, Takatsuki, Japan.
authors.forename: Haruhito
authors.initials: H
authors.lastname: Azuma
authors.affiliation: Department of Urology, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Matsubara
authors.affiliation: Department of Urology, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Graduate School of Science and Engineering, Chuo University, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Urology, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
authors.affiliation: Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D016898:Interferon-alpha / Q000008:administration & dosage* / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D008297:Male; D008875:Middle Aged; D058990:Molecular Targeted Therapy; D009362:Neoplasm Metastasis; D020641:Polymorphism, Single Nucleotide / Q000235:genetics; D011379:Prognosis; D050796:STAT3 Transcription Factor / Q000235:genetics; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D000970:Antineoplastic Agents; D016898:Interferon-alpha; D050796:STAT3 Transcription Factor; C494086:STAT3 protein, human
keywords: The Era of molecular targeted therapy; interferon-α; overall survival; prognostic factors; renal cell carcinoma