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Does Metastatic Tumor Shrinkage Influence Overall Survival in Renal Cell Carcinoma?

By: Vanessa A. Carter, BS
Posted: Thursday, February 25, 2021

At the 2020 Annual Meeting of the Society of Urologic Oncology (SUO), Alberto C. Pieretti, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues presented their research on the correlation between metastatic tumor shrinkage and overall survival in patients with metastatic clear cell renal cell carcinoma (Abstract 102). Their findings suggested an association between metastatic tumor shrinkage of at least 10% and increased overall survival in patients who underwent deferred cytoreductive nephrectomy.

The researchers reviewed their institutional database and focused on 211 patients with metastatic clear cell renal cell carcinoma. All patients received immunotherapy, preoperative targeted molecular therapy, or a combination of the two, followed by deferred cytoreductive nephrectomy. From cross-sectional images obtained at initial diagnosis and before deferred cytoreductive nephrectomy, metastatic and primary tumor longest diameters were calculated for comparison.

Primary tumor shrinkage of at least 10% was observed in 41.4% of patients, and metastatic tumor shrinkage of at least 10% occurred in 64.1% of patients. Primary and metastatic tumor shrinkage of at least 10% and median overall survival showed similar immunotherapy results, preoperative targeted molecular therapy, and combination therapy.

The median overall survival for patients with metastatic tumor shrinkage of at least 10% was 47.5 months, compared with 22.5 months in patients who experienced less than 10% tumor shrinkage. Based on the univariable analysis, metastatic (hazard ratio = 0.5) and primary (hazard ratio = 0.6) tumor shrinkage of at least 10% was associated with improved overall survival. Additionally, from multivariable analysis, metastatic tumor shrinkage of at least 10% was also associated with better overall survival (hazard ratio = 0.5).

Disclosure: No disclosure information was provided.



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