Although in metastatic renal cell carcinoma (mRCC) patients with intermediate and poor risk the benefit of combination strategies versus tyrosine kinase inhibitor (TKI) has been ascertained, in those with favorable risk data are ambiguous. Herein, we investigated the impact of number and type of metastatic site in patients with favorable risk to contribute to the best therapeutic choice. Multicenter data regarding patients with favorable risk mRCC carcinoma receiving first-line TKIs, sunitinib or pazopanib, were retrospectively collected. We divided our population into 2 groups based on the number of metastatic sites and analyzed its impact on tumor response and efficacy outcome. The Kaplan-Meier method was used to estimate efficacy outcomes and the log-rank test to examine differences between subgroups. A total of 107 patients with a median age of 69 years were included in the final analysis. Patients with 1 metastatic site, compared with patients with > 1 site, had a significantly longer overall survival (OS) (not reached . 66 months) and a trend, although not statistically significant, of better progression-free survival (PFS) (31 vs. 17 months). In patients with 1 metastatic site, liver involvement was correlated with worse PFS and OS at the univariate analysis (01) and was confirmed as independent poor prognostic factor for PFS at multivariate analysis. In conclusion, we reported a longer OS in favorable risk mRCC patients receiving TKI with only 1 metastatic site. Nevertheless, in patients with a single metastatic site, hepatic involvement correlated with worse PFS compared to other metastatic sites.

中文翻译：

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接受舒尼替尼或帕唑帕尼治疗的有利风险肾细胞癌转移部位的影响

尽管在中度和低度风险的转移性肾细胞癌 (mRCC) 患者中，联合策略相对于酪氨酸激酶抑制剂 (TKI) 的益处已得到确定，但在具有有利风险数据的患者中，联合策略的益处尚不明确。在此，我们研究了转移部位的数量和类型对具有有利风险的患者的影响，以有助于最佳的治疗选择。回顾性收集接受一线 TKI、舒尼替尼或帕唑帕尼治疗的有利风险转移性肾细胞癌患者的多中心数据。我们根据转移部位的数量将人群分为两组，并分析其对肿瘤反应和疗效结果的影响。 Kaplan-Meier 方法用于估计疗效结果，并使用对数秩检验来检查亚组之间的差异。最终分析共纳入107名患者，中位年龄69岁。与具有 > 1 个转移部位的患者相比，具有 1 个转移部位的患者的总生存期 (OS) 显着较长（未达到 66 个月），并且有更好的无进展生存期 (PFS) 趋势，尽管没有统计学意义（31 vs. 17 个月）。在具有 1 个转移部位的患者中，单变量分析中肝脏受累与较差的 PFS 和 OS 相关 (01)，并且在多变量分析中被证实是 PFS 的独立不良预后因素。总之，我们报道了仅 1 个转移部位且接受 TKI 治疗的有利风险 mRCC 患者的 OS 较长。然而，在具有单一转移部位的患者中，与其他转移部位相比，肝脏受累与较差的 PFS 相关。