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Overall survival in Swedish patients with renal cell carcinoma treated in the period 2002 to 2012: Update of the RENCOMP study with subgroup analysis of the synchronous metastatic and elderly populations

Journal article
Authors M. Lindskog
T. Wahlgren
R. Sandin
J. Kowalski
M. Jakobsson
Sven Lundstam
B. Ljungberg
U. Harmenberg
Published in Urologic Oncology-Seminars and Original Investigations
Volume 35
Issue 9
Pages 541.e15-541.e22
ISSN 1078-1439
Publication year 2017
Published at Institute of Clinical Sciences, Department of Urology
Pages 541.e15-541.e22
Language en
Links doi.org/10.1016/j.urolonc.2017.05.0...
Keywords Sweden, Renal cell carcinoma, Targeted therapy, Sunitinib, Survival, phase-iii trial, targeted therapy, interferon-alpha, 3rd-line therapy, double-blind, efficacy, cancer, sorafenib, sunitinib, guidelines, Oncology, Urology & Nephrology
Subject categories Urology and Nephrology

Abstract

Background: This retrospective study investigated overall survival (OS) and factors influencing OS in Swedish patients with metastatic renal cell carcinoma (mRCC) during the pre- (2002-2005), early (2006-2008), and late (2009-2012) targeted therapy (TT) era. Methods: Three national Swedish registries identified patients with mRCC. Median OS was estimated using the Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards regression. Subgroup analysis was conducted for patients with synchronous metastases (Ml) and the elderly (aged >= 75 y). Results: A total of 4,217 patients with mRCC were identified, including 1,533 patients with Ml and 1,275 elderly patients. For patients with mRCC diagnosed in 2002 to 2005, 2006 to 2008, and 2009 to 2012, median OS was 10.0, 13.0, and 18.0 months. Similarly, median OS improved in the M1 and elderly populations. Elderly patients were less likely to be prescribed TT (>= 75 vs. <75 y): 18.3 vs. 63.5% (in 2006-2008) and 28.6% vs. 55.9% (in 2009-2012). Diagnosis of mRCC in 2009 to 2012, nephrectomy and TT prescription were associated with improved OS in the total mRCC, Ml, and elderly populations. Conclusion: This real-world study showed continued significant improvement in mRCC OS during the late TT era, including in Ml and elderly populations. TT should be considered for all patients with mRCC based on tolerability, regardless of age. (C) 2017 Elsevier Inc. All rights reserved.

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