Initial computed tomography imaging details during first-line systemic therapy is of significant prognostic value in patients with naïve, unresectable metastatic renal cell carcinomaReport as inadecuate




Initial computed tomography imaging details during first-line systemic therapy is of significant prognostic value in patients with naïve, unresectable metastatic renal cell carcinoma - Download this document for free, or read online. Document in PDF available to download.

Purpose

We aimed to determine the prognostic significance of computed tomography imaging parameters of unresectable primary renal tumor lesions, obtained at baseline and at first follow-up, on overall survival in naïve, unresectable metastatic renal cell carcinoma patients during first-line systemic therapy.

Materials and methods

Clinicopathological parameters of 56 patients treated between 2007 and 2015, including imaging parameters such as the longest tumor diameter, necrotic area diameter, and attenuation in primary renal tumor lesions on baseline vs. follow-up computed tomography, were retrospectively reviewed to derive predictive factors of overall survival. The best overall response was measured according to the RECIST v1.1.

Results

The median treatment period was 206.3 days and the median follow-up was 14.6 months. Forty-four 78.6% patients progressed after a median 4.6 months of progression-free survival, and 6 10.7% patients survived with a median overall survival of 12.5 months. Multivariate analysis showed that the baseline tumor diameter hazard ratio HR 0.903 and mean attenuation HR 0.936, change of tumor diameter HR 0.714 and necrosis diameter HR 0.861, change in the percentage of tumor diameter HR 1.483 and of necrosis diameter HR 1.028 between baseline and follow-up computed tomography images; treatment duration HR 0.986 and baseline serum hemoglobin HR 1.790 and albumin level HR 0.060 were significant factors for overall survival p<0.05.

Conclusion

The study showed that baseline and first follow-up computed tomography findings of primary renal lesions during first-line systemic therapy are useful and significant predictors of OS in patients with naïve unresectable mRCC.



Author: Sung Han Kim, Weon Seo Park, Sun Ho Kim, Ho Kyung Seo, Jae Young Joung, Kang Hyun Lee, Jinsoo Chung

Source: http://plos.srce.hr/



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