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Published in: World Journal of Urology 7/2016

01-07-2016 | Original Article

Does the onset of bone metastasis in sunitinib-treated renal cell carcinoma patients impact the overall survival?

Authors: P. Ivanyi, J. Koenig, A. Trummer, J. F. Busch, C. Seidel, C. W. Reuter, A. Ganser, V. Grünwald

Published in: World Journal of Urology | Issue 7/2016

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Abstract

Purpose

To evaluate the impact of bone metastasis (BM) onset toward prognosis in metastatic renal cell carcinoma (mRCC) patients treated with sunitinib.

Methods

mRCC patients with BM and sunitinib as first targeted therapy between May 2005 and December 2012 were retrospectively analyzed. Patients with synchronous (s) BM or metachronous (m) BM were compared with regard to treatment and outcome [time to clinical progression (TTcP), overall survival (OS), skeletal-related events (SRE)]. Descriptive statistics, Kaplan–Meier estimation of TTcP and OS, Cox regression analyses, and a landmark analysis were administered.

Results

BM was identified in 127 mRCC patients; thereof, 82 sunitinib-treated patients were analyzed [sBM n = 57 (69.5 %), mBM n = 25 (30.5 %)]. Higher tumor grading (p = 0.029), male predominance (p = 0.02), and less second-line therapy (p = 0.001) were detected in sBM compared to mBM. SRE remained similar between subgroups (p = 0.462). TTcP during sunitinib was similar [median sBM 8.1 (95 % CI 3.9–12.3) vs. mBM 8.7 (95 % CI 2.7–14.8) months, p = 0.903]. OS remained significantly inferior in sBM patients compared to mBM [median sBM 21.1 (95 % CI 16–26.2) months vs. mBM 38.5 (95 % CI 15–62) months, p = 0.001], which was confirmed by landmark analyses at 1.5, 3, 6, 9, and 12 months. However, OS after occurrence of BM was similar in both groups [median sBM 24.2 (95 % CI 17.3–31.1) months vs. mBM 17.2 (95 % CI 8.4–26) months, p = 0.519].

Conclusions

mBM is associated with an improved OS compared to sBM in mRCC with sunitinib treatment, despite similar efficacy of sunitinib treatment in both groups of patients.
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Metadata
Title
Does the onset of bone metastasis in sunitinib-treated renal cell carcinoma patients impact the overall survival?
Authors
P. Ivanyi
J. Koenig
A. Trummer
J. F. Busch
C. Seidel
C. W. Reuter
A. Ganser
V. Grünwald
Publication date
01-07-2016
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 7/2016
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-015-1707-0

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