Clinic for Internal Medicine (Tumor Research) and Department of Urology, University of Duisburg-Essen and German Cancer Consortium (DKTK)-University Hospital Essen, Essen, Germany
Viktor Grünwald , Christian Thomas , Maria De Santis , Christian Gratzke , Felix Chun , Rene Mager , Margitta Retz , Gunhild Von Amsberg , Philipp Ivanyi , Bolenz Christian , Hubert Kübler , Boris A. Hadaschik , Svenja Hahn , Ian Erhard , Bastian Reiter , Martin Lablans , Janne Vehreschild , Daniel Brucker , Daniel Maier
Background: Nephrectomy and risk-adapted adjuvant pembrolizumab are standard treatments in localized renal cell carcinoma (RCC). Risk of recurrence from clinical trials is utilized to council patients. However, recurrence and survival in real-world practice may differ. We report real-world outcome data of patients with RCC from the German Cancer Consortium’s Clinical Communication Platform, a federated data warehouse infrastructure for oncological real-world evidence. Methods: Adult patients from routine care and nephron sparing surgery (NSS) or nephrectomy (Nx) for non-metastatic RCC between 2013-2022 at tertiary German cancer centers were retrospectively analyzed. Clear cell (cc), papillary (p) or NOS histologies were eligible. Kaplan-Meier-analyses were conducted stratified by pathological stage for DFS (Disease-Free-Survival) and OS (overall Survival). Results: 1,291 patients received NSS/Nx. 1,271 (98.5%) were R0/1. Median follow-up: 37.8 mo. (IQR 13.08; 65,74). 754 patients had ccRCC with a mean age of 63.5 y (SD: 12.1), 40% were female. 221 had pRCC, mean age was 62.1 (SD 12.6) and 36.8% were female. 165 had NOS, mean age was 63.3 (SD 12.4) and 36.8% were female. 151 patients had other histologies. Survival outcomes are reported in table 1. Conclusions: Morphologic RCC types and T-stages inform on recurrence and prognosis. Our study advises on real-world recurrence and survival rates in patients with different RCC types, which may be used to counsel patients with regards to adjuvant therapy in the clinic. A major limitation is the retrospective nature of the analysis.
ccRCC | n=754 | pRCC | n=221 | NOS | n=165 | ||||||||||||
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T-stage, fraction by RCC type | Total | T1 40.9% | T2 20.8% | T3 30.8% | Total | T1 51.4% | T2 23.5% | T3 22.0% | Total | T1 47.1% | T2 11.4% | T3 28.6% | |||||
5-year DFS (%, 95%CI) | 83.2 (80.6-86.9) | 84.6 (81.6-87.7) | 83.3 (74.4-93.3) | 80.3 (73.7-87.5) | 85.9 (81.2-90.8) | 88.3 (83.6-93.4) | 85.7 (72.0-100) | 70.0 (52.5-93.3) | 87.0 (82.0-92.5) | 87.5 (81.4-94.1) | 91.7 (77.3-100) | 87.1 (76.1-99.7) | |||||
5-year OS (%, 95%CI) | 82.7 (79.2-86.3) | 85-6 (82.6-88.6) | 86.7 (78.5-95.7) | 83.5 (77.2-90.2) | 82.0 (75.9-88.7) | 88.3 (83.6-93.4) | 85.7 (72.0-100) | 75.0 (58.2-96.6) | 77.2 (68.8-86.6) | 88.5 (82.5-94.8) | 91.7 (77.3-100) | 87.1 (76.1-99.7) |
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