Outcome of Advanced Renal Cell Carcinoma Arising in End-stage Renal Disease: Comparison with Sporadic Renal Cell Carcinoma

Overview

Journal Clin Exp Nephrol

Publisher Springer

Specialty Nephrology

Date 2021 Feb 28

PMID 33641007

Citations 1

Authors

Hiroki Ishihara

Hironori Fukuda

Hidekazu Tachibana

Kazuhiko Yoshida

Hirohito Kobayashi

Toshio Takagi

Junpei Iizuka

Hideki Ishida

Yoji Nagashima

Tsunenori Kondo

Kazunari Tanabe

Affiliations

Soon will be listed here.

Abstract

Background: The data regarding oncological outcome in advanced renal cell carcinoma (RCC) arising in end-stage renal disease (ESRD) are limited.

Methods: Patients diagnosed with advanced RCC on maintenance dialysis therapy (ESRD-RCC) and treated with tyrosine kinase inhibitors (TKIs) were retrospectively evaluated. Progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) after initiation of first-line TKI therapy in ESRD-RCC patients were compared to those in RCC arising in the general population (sporadic RCC).

Results: A total of 36 and 240 patients were diagnosed with advanced ESRD-RCC and sporadic RCC, respectively. PFS and OS were significantly shorter in patients with ESRD-RCC than in those with sporadic RCC (p = 0.0004 and p = 0.0045). After adjusting for histopathological type, MSKCC risk and liver metastasis status, ESRD status (ESRD-RCC vs. sporadic RCC) was not an independent risk factor for PFS or OS (both, p > 0.05). The ORR tended to be lower in patients with ESRD-RCC than in those with sporadic RCC (11% vs. 28%, p = 0.0833). In 34 patients with ESRD-RCC treated with sorafenib, longer duration of dialysis was an independent prognostic factor for shorter OS (hazard ratio 3.21, p = 0.0370).

Conclusions: Outcome of advanced ESRD-RCC was poorer than that of sporadic RCC, but this finding was affected by other prognostic factors. Nevertheless, the study suggested that advanced ESRD-RCC was not an indolent disease. Additionally, patients with a longer duration of dialysis therapy might require careful monitoring.

Citing Articles

Comparison of Outcomes Between Therapeutic Combinations Based on Immune Checkpoint Inhibitors or Tyrosine Kinase Inhibitor Monotherapy for First-Line Therapy of Patients with Advanced Renal Cell Carcinoma Outside of Clinical Trials: A Real-World....

Ishihara H, Nemoto Y, Nakamura K, Tachibana H, Ikeda T, Fukuda H Target Oncol. 2023; 18(2):209-220.

PMID: 36941516 DOI: 10.1007/s11523-023-00956-8.

References

Stewart J, Buccianti G, Agodoa L, Gellert R, McCredie M, Lowenfels A . Cancers of the kidney and urinary tract in patients on dialysis for end-stage renal disease: analysis of data from the United States, Europe, and Australia and New Zealand. J Am Soc Nephrol. 2002; 14(1):197-207. DOI: 10.1097/01.asn.0000039608.81046.81. View

Holley J . Screening, diagnosis, and treatment of cancer in long-term dialysis patients. Clin J Am Soc Nephrol. 2007; 2(3):604-10. DOI: 10.2215/CJN.03931106. View

Lin M, Kuo M, Hung C, Wu W, Chen L, Yu M . Association of dialysis with the risks of cancers. PLoS One. 2015; 10(4):e0122856. PMC: 4395337. DOI: 10.1371/journal.pone.0122856. View

Stewart J, Vajdic C, van Leeuwen M, Amin J, Webster A, Chapman J . The pattern of excess cancer in dialysis and transplantation. Nephrol Dial Transplant. 2009; 24(10):3225-31. DOI: 10.1093/ndt/gfp331. View

Maisonneuve P, Agodoa L, Gellert R, Stewart J, Buccianti G, Lowenfels A . Cancer in patients on dialysis for end-stage renal disease: an international collaborative study. Lancet. 1999; 354(9173):93-9. DOI: 10.1016/s0140-6736(99)06154-1. View

Hurst F, Jindal R, Fletcher J, Dharnidharka V, Gorman G, Lechner B . Incidence, predictors and associated outcomes of renal cell carcinoma in long-term dialysis patients. Urology. 2011; 77(6):1271-6. DOI: 10.1016/j.urology.2011.01.007. View

Stiles K, Moffatt M, Agodoa L, Swanson S, Abbott K . Renal cell carcinoma as a cause of end-stage renal disease in the United States: patient characteristics and survival. Kidney Int. 2003; 64(1):247-53. DOI: 10.1046/j.1523-1755.2003.00060.x. View

Thomas B, Wulf S, Bikbov B, Perico N, Cortinovis M, Courville de Vaccaro K . Maintenance Dialysis throughout the World in Years 1990 and 2010. J Am Soc Nephrol. 2015; 26(11):2621-33. PMC: 4625679. DOI: 10.1681/ASN.2014101017. View

Neuzillet Y, Tillou X, Mathieu R, Long J, Gigante M, Paparel P . Renal cell carcinoma (RCC) in patients with end-stage renal disease exhibits many favourable clinical, pathologic, and outcome features compared with RCC in the general population. Eur Urol. 2011; 60(2):366-73. DOI: 10.1016/j.eururo.2011.02.035. View

10.

Breda A, Lucarelli G, Luccarelli G, Rodriguez-Faba O, Guirado L, Facundo C . Clinical and pathological outcomes of renal cell carcinoma (RCC) in native kidneys of patients with end-stage renal disease: a long-term comparative retrospective study with RCC diagnosed in the general population. World J Urol. 2014; 33(1):1-7. DOI: 10.1007/s00345-014-1248-y. View

11.

Klatte T, Seitz C, Waldert M, de Martino M, Kikic Z, Bohmig G . Features and outcomes of renal cell carcinoma of native kidneys in renal transplant recipients. BJU Int. 2009; 105(9):1260-5. DOI: 10.1111/j.1464-410X.2009.08941.x. View

12.

Kojima Y, Takahara S, Miyake O, Nonomura N, Morimoto A, Mori H . Renal cell carcinoma in dialysis patients: a single center experience. Int J Urol. 2006; 13(8):1045-8. DOI: 10.1111/j.1442-2042.2006.01498.x. View

13.

Hashimoto Y, Takagi T, Kondo T, Iizuka J, Kobayashi H, Omae K . Comparison of prognosis between patients with renal cell carcinoma on hemodialysis and those with renal cell carcinoma in the general population. Int J Clin Oncol. 2015; 20(5):1035-41. DOI: 10.1007/s10147-015-0812-9. View

14.

Hayami N, Ubara Y, Okaneya T, Fujii T, Nagashima Y, Ohashi K . Outcome of renal cell carcinoma in patients on dialysis compared to non-dialysis patients. Semin Dial. 2020; 33(4):316-321. DOI: 10.1111/sdi.12888. View

15.

Song C, Hong S, Chung J, Byun S, Kwak C, Jeong C . Renal cell carcinoma in end-stage renal disease: Multi-institutional comparative analysis of survival. Int J Urol. 2016; 23(6):465-71. DOI: 10.1111/iju.13084. View

16.

Masini C, Sabbatini R, Porta C, Procopio G, Di Lorenzo G, Onofri A . Use of tyrosine kinase inhibitors in patients with metastatic kidney cancer receiving haemodialysis: a retrospective Italian survey. BJU Int. 2012; 110(5):692-8. DOI: 10.1111/j.1464-410X.2012.10946.x. View

17.

Shetty A, Matrana M, Atkinson B, Flaherty A, Jonasch E, Tannir N . Outcomes of patients with metastatic renal cell carcinoma and end-stage renal disease receiving dialysis and targeted therapies: a single institution experience. Clin Genitourin Cancer. 2014; 12(5):348-53. PMC: 4160412. DOI: 10.1016/j.clgc.2014.01.004. View

18.

Escudier B, Eisen T, Stadler W, Szczylik C, Oudard S, Siebels M . Sorafenib in advanced clear-cell renal-cell carcinoma. N Engl J Med. 2007; 356(2):125-34. DOI: 10.1056/NEJMoa060655. View

19.

Motzer R, Hutson T, Tomczak P, Michaelson M, Bukowski R, Rixe O . Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N Engl J Med. 2007; 356(2):115-24. DOI: 10.1056/NEJMoa065044. View

20.

Kondo T, Takagi T, Kobayashi H, Iizuka J, Nozaki T, Hashimoto Y . Superior tolerability of altered dosing schedule of sunitinib with 2-weeks-on and 1-week-off in patients with metastatic renal cell carcinoma--comparison to standard dosing schedule of 4-weeks-on and 2-weeks-off. Jpn J Clin Oncol. 2014; 44(3):270-7. DOI: 10.1093/jjco/hyt232. View