Clinical characteristics and prognosis of patients with renal cell carcinoma and liver metastasis.

Abstract

The prognosis of patients with renal cell carcinoma (RCC) and liver metastasis (LM) is poor. We evaluated the clinical characteristics, prognosis and prognostic factors of RCC patients with LM. A total of 25 patients who underwent radical or partial nephrectomy (Nx) for RCC between November, 1980 and April, 2013 at the National Defense Medical College, Tokorozawa, Saitama, Japan, with LM at initial presentation or following Nx, were included in this study. The association between prognosis following development of LM and clinicopathological parameters was analyzed. The Cox proportional hazards regression model was used to identify prognostic predictors. The median cancer-specific survival (CSS) following LM diagnosis was 10.6 months. The presence of sarcomatoid differentiation, Eastern Cooperative Oncology Group performance status (ECOG PS) ≥2, C-reactive protein ≥1.0 mg/dl, corrected calcium ≥10 mg/dl and presence of multiple organ metastases, were identified as CSS predictors. The multivariate analysis identified ECOG PS ≥2 as an independent CSS predictor. Nine patients survived for >20 months following LM diagnosis and 1 patient, who received treatment with tyrosine kinase inhibitors (TKIs) for LM, exhibited stable disease for 5 years. Nine patients underwent local LM treatment. Two patients, who underwent hepatic resection, survived for 55.1 and 22 months, respectively. In conclusion, RCC patients with LM may benefit from local LM treatment if they have a limited number of metastases in addition to LM and if their ECOG PS is satisfactory. Indeed, a proportion of RCC patients with LM benefit from TKI therapy. Furthermore, RCC patients with LM and ECOG PS ≥2 apparently have a poor prognosis, regardless of local or systemic therapies.