Cancer-specific survival outcomes among patients treated during the cytokine era of kidney cancer (1989-2005)

摘要: BACKGROUND. The management of renal cell carcinoma (RCC) is evolving toward less extirpative surgery and the use targeted therapy. The authors set out to provide a benchmark against which emerging therapies should be measured. METHODS. A prospective database including clinical pathological variables for 1632 patients with RCC treated between 1989 2005 was queried. Patients were stratified using University California-Los Angeles Integrated Staging System (UISS) into low-, intermediate-, high-risk groups. Disease-specific survival (DSS) measured. Response systemic therapy advanced disease assessed. RESULTS. Nephrectomy performed in 1492 patients. Overall 5-, 10-, 15-year DSS 55%, 40%, 29%. For localized disease, 5- 10-year UISS groups 97% 92%, 81% 61%, 62% 41%, respectively. metastatic 41% 31%, 18% 7%, 8% 0%, receiving immunotherapy (n = 453) had complete response 7% (median [MS], 120+ months), partial 15% (MS, 42.8 stable 33% 38.6 progressive 45% 11.6 months). CONCLUSIONS. Most do well alone, but effective adjuvant needed identified as at high risk recurrence. newer potentially toxic treatments least those achieved aggressive surgical resection immunotherapy. Cancer 2008. © 2008 American Society.