825P - Impact on overall survival of glandular metastasis in patients with metastatic clear cell renal cell carcinoma. On behalf of the Renal Cross Channe...

Date 27 September 2014
Event ESMO 2014
Session Poster Display session
Topics Renal Cell Cancer
Presenter Gwenaëlle Gravis
Citation Annals of Oncology (2014) 25 (suppl_4): iv280-iv304. 10.1093/annonc/mdu337
Authors G. Gravis1, B. Chanez2, L. Derosa3, B. Beuselinck4, B. Laguerre5, P. Barthelemy6, P.E. Brachet7, F. Joly Lobbedez8, B. Escudier9, G.D. Stewart10, D. Harrison11, A. Laird12, N. Vasudev13, C. Ralph13, J. Larkin14, H. Lote15, J. Walz16, J. Thomassin17, N. Salem18, J.M. Boher19
  • 1Medical Oncology, Paoli Calmettes, 13009 - Marseille/FR
  • 2Medical Oncology, Institut Paoli-Calmettes, 13009 - Marseille/FR
  • 3Medical Oncology, Institut Gustave Roussy, Villejuif/FR
  • 4Medical Oncology, Leuven Cancer Institute, Leuven/BE
  • 5Medical Oncology, Centre Eugène Marquis, Rennes/FR
  • 6Medical Oncology, Hôpital de Hautepierre, Strasbourg/FR
  • 7Medical Oncology, Centre François Baclesse, Caen/FR
  • 8Medocal Oncology, Centre Francois Baclesse, 14076 - Caen CEDEX /FR
  • 9-, Institut de Cancérologie Gustave Roussy, 94805 - Villejuif/FR
  • 10Department Of Urology And Edinburgh Urological Cancer Group, Western General Hospital, EH16 4SA - Edinburgh/GB
  • 11School Of Medicine, St. Andrew’s University, Edinburgh/GB
  • 12Urological Cancer Group, University of Edinburgh, Edinburgh/GB
  • 13Medical Oncology, St James’s Institute of Oncology, Leeds/GB
  • 14Department Of Medicine, Royal Marsden Hospital, SW3 6JJ - London/GB
  • 15Medical Oncology, Royal Marsden Hospital, London/GB
  • 16Urologic Oncology, Institut Paoli-Calmettes, 13009 - Marseille/FR
  • 17Biopathology, Institut Paoli-Calmettes, 13009 - Marseille/FR
  • 18Radiotherapy, Paoli Calmettes, Marseille/FR
  • 19Bioinformatics, Institut Paoli-Calmettes, marseille/FR

Abstract

Aim

Glandular metastasis (GM) as defined by pancreas, breast, parotid, thyroid and contralateral adrenal metastasis are rare in clear cell renal cell carcinoma. We have performed a multicenter comparison of metastatic clear cell RCC (mRCC) with GM and non-GM to determine if GM impacts on overall survival (OS).

Methods

Data were collected from mRCC pts with GM or non-GM at metastatic presentation. GM: pts with at least one GM with or without other sites. Non-GM: pts without GM at metastatic presentation. Pts were treated in 5 French, 1 Belgian and 3 UK centers between January 2004 and October 2013. Association between OS and site of metastasis was assessed using the log-rank test for univariate analysis and the chi-square test for multivariable Cox regression.

Results

188 GM and 453 non-GM mRCC pts were analyzed. The majority were male (70.2%), median age was 59y, with no difference between the GM and non-GM groups. Interval from diagnosis to metastasis was 25.7 months (mo) (0.03-272.8)for GM and 4.8 mo (0.03-334) for non-GM (p < 0.001). 39% GM pts were MSKCC favorable risk compared with 23% non-GM pts (p <0.0001) and 6.7% GM pts were MSKCC poor risk vs 16.7% non-GM. Fuhrman grade was I/II in 48.7% GM pts and 33.6% in the non-GM (p = 0.005). Median follow-up was 82.4 mo (68.9-89.5). Median OS was 64.8 mo (52.7-86) for GM and 39.8 mo (34.8-46.1) for non-GM (HR = 1.66 [95% CI = 1.32-2.1], p < 0.001). Age (<60y vs >60y), delay between renal tumor and metastatic diagnosis, MSKCC risk group and GM or non-GM group were significant parameters in univariate OS analysis (p < 0.001). In a multivariate analysis adjusted according to MSKCC risk group, GM status was a strong prognostic factor (HR = 0.76 [95% CI = 0.59-0.98], p < 0.035).

Conclusions

This large retrospective study shows that the presence of at least one GM at metastatic presentation of clear cell mRCC was associated with a significantly longer OS compared to non-GM pts. The presence of GM vs non-GM disease was an independent prognostic factor for OS. Further translational studies will be performed on matched primary tumor and metastasis samples to assess molecular differences between GM and non-GM.

Disclosure

All authors have declared no conflicts of interest.