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Comparison of three risk stratification models for non-clear cell renal cell carcinoma patients treated with temsirolimus as first-line therapy

Korean Journal of Internal Medicine 2020년 35권 1호 p.185 ~ 193
 ( Lee In-Hee ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Internal Medicine

강병욱 ( Kang Byung-Woog ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Internal Medicine
김종광 ( Kim Jong-Gwang ) - Kyungpook National University School of Medicine Kyungpook National University Chilgok Hospital Department of Internal Medicine
배우균 ( Bae Woo-Kyun ) - Chonnam National University Medical School Department of Internal Medicine
 ( Ki Myung-Seo ) - Chonnam National University Medical School Department of Internal Medicine
박인근 ( Park In-Keun ) - Gachon University Gil Medical Center Department of Internal Medicine
조재철 ( Jo Jae-Cheol ) - University of Ulsan College of Medicine Ulsan University Hospital Department of Hematology and Oncology
김진영 ( Kim Jin-Young ) - Keimyung University Dongsan Medical Center Department of Internal Medicine
고성애 ( Koh Sung-Ae ) - Yeungnam University College of Medicine Department of Internal Medicine
이경희 ( Lee Kyung-Hee ) - Yeungnam University College of Medicine Department of Internal Medicine
조윤영 ( Cho Yoon-Young ) - Daegu Catholic University Medical Center Department of Hematology/Oncology
류헌모 ( Ryoo Hun-Mo ) - Daegu Catholic University Medical Center Department of Hematology/Oncology
곽상규 ( Kwak Sang-Gyu ) - Daegu Catholic University Medical Center Department of Medical Statistics
이중림 ( Lee Jung-Lim ) - Daegu Fatima Hospital Department of Hemato-Oncology
이선아 ( Lee Sun-Ah ) - Daegu Fatima Hospital Department of Hemato-Oncology

Abstract


Background/Aims: For metastatic renal cell carcinoma (RCC), various prognostic scoring systems have been developed. However, owing to the low prevalence of nonclear cell RCC, the three most commonly used tools were mainly developed based on patients with clear cell histology. Accordingly, this study applied three prognostic models to Korean non-clear cell RCC patients treated with first-line temsirolimus.

Methods: This study analyzed data for 74 patients with non-clear cell RCC who were treated with temsirolimus as the first-line therapy at eight medical centers between 2011 and 2016. The receiver-operating characteristic (ROC) curves for the different prognostic models were analyzed.

Results: Twenty-seven (36.5%), 24 (32.4%), and 44 patients (59.5%) were assigned to the poor prognosis groups of the Memorial Sloan-Kettering Cancer Center (MSKCC), International Metastatic RCC Database Consortium (IMDC), and Advanced Renal Cell Carcinoma (ARCC) risk stratification models, respectively. All three prognostic models reliably discriminated the risk groups to predict progression-free survival and overall survival (p < 0.001). The area under the ROC curve (AUC) for progression and survival was highest for the ARCC model (0.777; 0.734), followed by the IMDC (0.756; 0.724) and the MSKCC (0.742; 0.712) models. Furthermore, the sensitivity and specificity for predicting progression were highest with the ARCC model (sensitivity 63.6%, specificity 85.7%), followed by the MSKCC (sensitivity 58.2%, specificity 86.5%) and the IMDC models (sensitivity 56.4%, specificity 85.7%).

Conclusions: All three prognostic models accurately predicted the survival of the non-clear cell RCC patients treated with temsirolimus as the first-line therapy. Furthermore, the ARCC risk model performed better than the other risk models in predicting survival.

키워드

Non-clear cell renal cell carcinoma; Temsirolimus; Prognostic model; Survival
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