828P - Bone metastases from RCC are not always associated with a poor prognosis

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Renal Cell Cancer
Presenter Daniele Santini
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors D. Santini1, M. Santoni2, A. Conti2, G. Procopio3, C. Porta4, T. Ibrahim5, S. Barni6, A. Fontana7, A. Berruti8, B. Vincenzi1, C. Ortega9, G. Carteni10, S.L. Fedeli11, V. Adamo12, E. Maiello13, R. Sabbatini14, A. Felici15, G. Tonini1, S. Bracarda16, S. Cascinu17
  • 1Medical Oncology, Campus Bio-Medico di Roma, 00128 - Roma/IT
  • 2Clinica Di Oncologia Medica, AO Ospedali Riuniti, Università Politecnica delle Marche, Ancona/IT
  • 3Oncologia Medica, Fondazione IRCCS - Istituto Nazionale dei Tumori, 20133 - Milano/IT
  • 4Oncologia Medica, Ospedale San Matteo, IT-27100 - Pavia/IT
  • 5Oncology, Istituto Tumori della Romagna I.R.S.T., Forli/IT
  • 6Medical Oncology, Azienda Ospedaliera Treviglio-Caravaggio, 24047 - Treviglio/IT
  • 7U.o. Oncologia Medica 2 Universitaria, Polo Oncologico, Ospedale S. Chiara, AOUP, 56100 - Pisa/IT
  • 8Oncologia Medica, Azienda Spedali Civili, Brescia/IT
  • 9Medical Oncology, IRCC - Fondazione Piemontese per la Ricerca sul Cancro, Candiolo/IT
  • 10Onco-hematology, Azienda Ospedaliera Cardarelli, Napoli/IT
  • 11Medical Oncology, Ospedali Riuniti Marche Nord, Pesaro/IT
  • 12Human Pathology, AOOR Papardo-Piemonte, 98125 - Messina/IT
  • 13Medical Oncology, Ospedale Casa Sollievo della Sofferenza, S.Giovanni Rotondo/IT
  • 14Medical Oncology, Ospedale Policlinico-Modena, IT-41100 - Modena/IT
  • 15Divisione Di Oncologia Medica A, Istituto Nazionale Tumori Regina Elena, 00144 - Roma/IT
  • 16Department Of Oncology, Ospedale San Donato and U.O.C. of Medical Oncology, 52100 - Arezzo/IT
  • 17Dipartimento Di Medicina Clinica E Biotecnologie A, AOU Ospedali Riuniti Ancona Università Politecnica delle Marche, 60126 - Ancona/IT

Abstract

Aim

Bone represents an unfavorable site of metastasis for renal cell carcinoma (mRCC), being associated with poorer prognosis compared to other metastatic sites. Aim of this study was to investigate for the presence of existing prognostic factors in patients with bone metastases from RCC.

Methods

Data of patients with bone metastases from RCC were retrospectively collected from 16 Italian centers. Survival estimates were quantified using Kaplan Meier curves. Age, sex, ECOG-Performance Status (PS), MSKCC group, tumor histology, presence of visceral metastases, time from nephrectomy to bone metastasis (classified into three groups: <1 year, between 1 and 5 years and >5 years) and time from bone metastasis to skeletal-related event (SRE) were included in the Cox analysis to investigate their prognostic relevance.

Results

470 patients were enrolled in this analysis; 235 of them were male. Median age was 64y (30-92y). In 19 patients (4%), bone was the only metastatic site; 277 patients (59%) had concomitant lung, 188 (40%) lymph nodes, 83 (18%) liver, 32 (7%) brain, and 12 (3%) adrenal metastases. Median time to bone metastasis was 16 months (range 0–44y). Median OS from bone disease was 17 months (95%CI:15-19 months). Number of metastatic sites (p = 0.01), concomitant metastases to liver (p = 0.006) and lymph-nodes (p = 0.02), high Fuhrman grade (p < 0.001) and non-clear cell histology (p = 0.013) were significantly associated with poor prognosis. Patients with late-relapsing (>5y) bone metastases had longer OS (22 months, 95%CI: 20-33) compared to patients with bone disease occurred <1y (13 months, 95%CI: 12-15) or between 1 and 5y (19 months, 95%CI: 12-26) from nephrectomy (p < 0.001), while no difference was found between these two last groups (p = 0.18). At multivariate analysis, ECOG-PS, MSKCC group and concomitant liver, lung or lymph node metastases resulted as independent predictors of OS in patients with bone disease.

Conclusions

The prognosis of RCC patients with bone metastases varies according to RCC histology, time of occurrence of bone metastases, presence of concomitant sites, MSKCC group and ECOG-PS.

Disclosure

All authors have declared no conflicts of interest.