TY - JOUR
T1 - Active surveillance of metastatic renal cell carcinoma
T2 - Results from a prospective observational study (MaRCC)
AU - Harrison, Michael R.
AU - Costello, Brian A.
AU - Bhavsar, Nrupen A.
AU - Vaishampayan, Ulka
AU - Pal, Sumanta K.
AU - Zakharia, Yousef
AU - Jim, Heather S.L.
AU - Fishman, Mayer N.
AU - Molina, Ana M.
AU - Kyriakopoulos, Christos E.
AU - Tsao, Che Kai
AU - Appleman, Leonard J.
AU - Gartrell, Benjamin A.
AU - Hussain, Arif
AU - Stadler, Walter M.
AU - Agarwal, Neeraj
AU - Pachynski, Russell K.
AU - Hutson, Thomas E.
AU - Hammers, Hans J.
AU - Ryan, Christopher W.
AU - Inman, Brant A.
AU - Mardekian, Jack
AU - Borham, Azah
AU - George, Daniel J.
N1 - Publisher Copyright:
© 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society.
PY - 2021/7/1
Y1 - 2021/7/1
N2 - Background: Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow-growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature. Methods: This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient-related outcomes. Wilcoxon 2-sample rank-sum tests and χ2 tests were used to assess differences between ST and AS cohorts in continuous and categorical variables, respectively. Kaplan-Meier survival curves were used to assess survival. Results: Of 504 patients, mRCC was initially managed by AS (n = 143) or ST (n = 305); 56 patients were excluded from the analysis. Disease was present in 69% of patients who received AS, whereas the remaining 31% had no evidence of disease. At data cutoff, 72 of 143 patients (50%) in the AS cohort had not received ST. The median overall survival was not reached (95% CI, 122 months to not estimable) in patients who received AS versus 30 months (95% CI, 25-44 months) in those who received ST. Quality of life at baseline was significantly better in patients who were managed with AS versus ST. Conclusions: AS occurs frequently (32%) in real-world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients.
AB - Background: Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow-growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature. Methods: This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient-related outcomes. Wilcoxon 2-sample rank-sum tests and χ2 tests were used to assess differences between ST and AS cohorts in continuous and categorical variables, respectively. Kaplan-Meier survival curves were used to assess survival. Results: Of 504 patients, mRCC was initially managed by AS (n = 143) or ST (n = 305); 56 patients were excluded from the analysis. Disease was present in 69% of patients who received AS, whereas the remaining 31% had no evidence of disease. At data cutoff, 72 of 143 patients (50%) in the AS cohort had not received ST. The median overall survival was not reached (95% CI, 122 months to not estimable) in patients who received AS versus 30 months (95% CI, 25-44 months) in those who received ST. Quality of life at baseline was significantly better in patients who were managed with AS versus ST. Conclusions: AS occurs frequently (32%) in real-world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients.
KW - active surveillance
KW - metastatic
KW - observational study
KW - renal cell carcinoma
UR - http://www.scopus.com/inward/record.url?scp=85103154871&partnerID=8YFLogxK
U2 - 10.1002/cncr.33494
DO - 10.1002/cncr.33494
M3 - Article
C2 - 33765337
AN - SCOPUS:85103154871
SN - 0008-543X
VL - 127
SP - 2204
EP - 2212
JO - Cancer
JF - Cancer
IS - 13
ER -