Effect of glandular @entity3 on overall survival of @entity1 with metastatic XXXX in the antiangiogenic therapy era.

@entity1 @entity1358 @entity3 @entity7419
BACKGROUND: Glandular @entity3 (GMs) (pancreas, breast, parotid, thyroid, or contralateral adrenal) are rare in metastatic @entity1358 (mccRCC). In a multicenter study we have assessed outcome from mccRCC with or without GMs. @entity1 AND METHODS: @entity1 with mccRCC and @entity7419 or non- @entity7419 (NGM) at first presentation of mccRCC, treated at 9 European centers (5 French, 3 UK, and 1 Belgian centers) between January 2004 and October 2013, were retrospectively analyzed. Association between overall survival (OS) and site of @entity3 was assessed using the log-rank test for univariate analysis and the chi-square test for multivariable Cox regression. RESULTS: In all, 138 @entity1 with @entity7419 mccRCC and 420 with NGM mccRCC were included; 37.2% @entity1 with @entity7419 had Memorial Sloan-Kettering Cancer Center (MSKCC)-favorable risk vs. 18% NGM @entity1 ; 10.7% @entity1 with @entity7419 had MSKCC-poor risk vs. 27% NGM @entity1 (P<0.0001). Median interval from @entity3 to treatment was 4.2 months (range: 0-221.3mo). Median OS was 61.5 months (51.4-81.6mo) for @entity7419 and 37.4 months (31.3-42mo) for NGM (hazard ratio [HR] = 1.7; 95% CI = 1.3-2.2, P<0.001). In univariate OS analysis, age, delay between initial diagnosis and @entity3 , MSKCC, bone/lung @entity3 , and @entity7419 or NGM group were significant parameters (P<0.001). In multivariate analysis, adjusted according to MSKCC risk group, NGM vs. @entity7419 was a strong prognostic factor (HR = 1.4; 95% CI = 1.0-1.8, P=0.026); bone or liver @entity3 were also significant (HR = 1.3; 95% CI = 1.1-1.7, P<0.02; HR = 1.4; 95% CI = 1.1-1.7, P<0.02, respectively). Even in @entity1 without bone or liver @entity3 , @entity7419 status was significant (HR = 1.8; 95% CI = 1.2-2.7, P<0.004). CONCLUSIONS: This large retrospective study shows that the presence of at least 1 @entity7419 site in development of mccRCC was associated with a significantly longer OS. The presence of GMs vs. NGM disease was an independent prognostic factor for survival irrespective of the presence or absence of bone or liver @entity3 . This finding could affect daily practice in which @entity1 with mccRCC and GMs should receive more aggressive treatment with a potential for long-term survival. The causal mechanisms for this improved prognosis in @entity7419 mccRCC would be evaluated in translational studies.
