コンドウ　ツネノリ   KONDOU Tsunenori
  近藤　恒徳
   所属   医学部 医学科（附属足立医療センター）
   職種   教授
Article types Original article
Language English
Peer review Peer reviewed
Title Outcome of advanced renal cell carcinoma arising in end-stage renal disease: comparison with sporadic renal cell carcinoma.
Journal Formal name：Clinical and experimental nephrology
Abbreviation：Clin Exp Nephrol
ISSN code：13421751/14377799
Domestic / ForeginForegin
Volume, Issue, Page 25(6),pp.674-682
Author and coauthor ISHIHARA Hiroki†*, FUKUDA Hironori, TACHIBANA Hidekazu, YOSHIDA Kazuhiko, KOBAYASHI Hirohito, TAKAGI Toshio, IIZUKA Junpei, ISHIDA Hideki, NAGASHIMA Yoji, KONDO Tsunenori, TANABE Kazunari
Publication date 2021/06
Summary BACKGROUND:The data regarding oncological outcome in advanced renal cell carcinoma (RCC) arising in end-stage renal disease (ESRD) are limited.METHODS:Patients diagnosed with advanced RCC on maintenance dialysis therapy (ESRD-RCC) and treated with tyrosine kinase inhibitors (TKIs) were retrospectively evaluated. Progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) after initiation of first-line TKI therapy in ESRD-RCC patients were compared to those in RCC arising in the general population (sporadic RCC).RESULTS:A total of 36 and 240 patients were diagnosed with advanced ESRD-RCC and sporadic RCC, respectively. PFS and OS were significantly shorter in patients with ESRD-RCC than in those with sporadic RCC (p = 0.0004 and p = 0.0045). After adjusting for histopathological type, MSKCC risk and liver metastasis status, ESRD status (ESRD-RCC vs. sporadic RCC) was not an independent risk factor for PFS or OS (both, p > 0.05). The ORR tended to be lower in patients with ESRD-RCC than in those with sporadic RCC (11% vs. 28%, p = 0.0833). In 34 patients with ESRD-RCC treated with sorafenib, longer duration of dialysis was an independent prognostic factor for shorter OS (hazard ratio 3.21, p = 0.0370).CONCLUSIONS:Outcome of advanced ESRD-RCC was poorer than that of sporadic RCC, but this finding was affected by other prognostic factors. Nevertheless, the study suggested that advanced ESRD-RCC was not an indolent disease. Additionally, patients with a longer duration of dialysis therapy might require careful monitoring.
DOI 10.1007/s10157-021-02038-3
PMID 33641007