Validation of clinical prognostic factors for survival in 1,043 Japanese patients with metastatic renal cell carcinoma (mRCC)

Abstract

20075 Background: Increasing number of patients and death of RCC has been reported in many countries including US and Japan. For choosing optimal treatment, determining risk of patients is essential. Although several prognostic factors of mRCC has been investigated, it was based on data of Caucasian. Since racial difference in biological character of cancer has been identified in several types of cancer, we validated the relationship between reported prognostic factors and survival in patients with mRCC in Japanese patients. Methods: We reviewed the medical records of 1,043 patients who had mRCC in the period to follow up, or at the first visit examination between 1988 and 2001 of 26 center in Japan. Results: Average survival of the 708 patients who died for renal cell carcinoma was 20.84 months. On the other hand, histological high grade (> WHO grade 2), metastasis at the first visit examination, short period from the first visit to recognition of metastasis (within 12 months), brain, bone or, liver metastasis, a number of metastatic sites (>1), high performance status (ECOG PS >0), high corrected serum calcium, low hemoglobin, and high CRP were prognostic factors for survival. However, LDH were not related. The median time to death with zero risk factor was 38.5 months, but those with >3 risk factors was 10 months. The patients with >4 risk factors was 4 months. Conclusions: Almost all prognostic factors reported in previous studies mainly based on Caucasian data had same impact on Japanese patients with mRCC. However, elevation of LDH did not have relationship to prognosis. Moreover, the time to death from diagnosis of mRCC in patients with poor prognostic factors was likely shorter compared with other studies. These results suggest Japanese with mRCC might have different character from those in US or European countries though further study in patient’s and tumor characteristics is warranted. No significant financial relationships to disclose.