Depressive symptoms have been associated with poorer OS in pts with mRCC (Prinsloo et al J Behav Med 2015). In other malignancies, BPSD has also been linked to poorer OS, but in mRCC, this association is unclear.
From a single institution, clinicopathologic information from pts with mRCC diagnosed between 2001 and 2016 were collected. Corresponding data from an electronic survey tool was obtained, comprised of 22 core items spanning physical, practical, functional and emotional domains. Each item was self-assessed by the pt on a 5-point Likert scale. The cumulative score was used to characterize BPSD as either as low BPSD (not a problem/mild) vs high BPSD (moderate/severe/very severe). Associations between BPSD level and clinicopathologic criteria (e.g., Heng risk) were interrogated, and OS was compared between patients characterized as low BPSD vs high BPSD.
A total of 102 pts (28.4% F/71.6% M) were assessed with a median age of 63 (range, 24-80). 73.4 and 26.6% pts were characterized as having good/intermediate and poor risk by Heng criteria, respectively. 79.3% pts and 20.7% pts were characterized as having low and high BPSD, respectively. No association was found between BPSD and age or gender. However, married patients have a longer survival (48.65 mos vs 34.52 mos, P=.07). Pts with poor risk mRCC were noted to have a higher BPSD as compared to pts with mild BPSD (75% vs 25%, P=.22). Median OS in the overall cohort was 44.2 months (mos). Although not statistically significant, a trend towards prolonged OS in pts with low BPSD vs high BPSD was observed (45.81 mos vs 35.95 mos, P = 81).
Our study suggests a potential link between Heng risk and BPSD, and further shows a compelling trend towards poorer OS in pts with higher BPSD. These results warrant confirmation in larger series. Targeted interventions to address elements related to BPSD have the potential to improve patient outcomes and should be developed.
Clinical trial identification
Legal entity responsible for the study
City of Hope Comprehensive Cancer Center
All authors have declared no conflicts of interest.