Brain metastasis from renal cell carcinoma: Presentation, recurrence, survival and implications for systemic therapy

Abstract

5097 Background: Patients with renal cell carcinoma brain metastasis (RCCBM) are frequently excluded from clinical trials. NCCN guidelines do not give clear recommendations regarding central nervous system (CNS) surveillance or therapy. We set out to define who should be screened and who should be considered for clinical trials after treatment of CNS lesions. Methods: A database of information was reviewed to determine presentation, clinical symptoms, number and size of lesions, use of and response to systemic therapy, treatment of BM, CNS disease free survival after treatment of original BM (CNS recurrence), and overall survival from time of diagnosis of BM. Results: A total of 138 patients with RCCBM were identified of whom 95% underwent treatment for their BM. Clear cell histology accounted for 92% of patients and 93% of patients had concomitant metastasis. Patients had CNS symptoms in 67% of cases. Symptomatic CNS tumors were larger (2.1 vs 1.3 cm, p <0.001) and more likely to receive a craniotomy (p<...