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Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC)
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 s...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251950/ https://www.ncbi.nlm.nih.gov/pubmed/33765337 http://dx.doi.org/10.1002/cncr.33494 |
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author | Harrison, Michael R. Costello, Brian A. Bhavsar, Nrupen A. Vaishampayan, Ulka Pal, Sumanta K. Zakharia, Yousef Jim, Heather S. L. Fishman, Mayer N. Molina, Ana M. Kyriakopoulos, Christos E. Tsao, Che‐Kai Appleman, Leonard J. Gartrell, Benjamin A. Hussain, Arif Stadler, Walter M. Agarwal, Neeraj Pachynski, Russell K. Hutson, Thomas E. Hammers, Hans J. Ryan, Christopher W. Inman, Brant A. Mardekian, Jack Borham, Azah George, Daniel J. |
author_facet | Harrison, Michael R. Costello, Brian A. Bhavsar, Nrupen A. Vaishampayan, Ulka Pal, Sumanta K. Zakharia, Yousef Jim, Heather S. L. Fishman, Mayer N. Molina, Ana M. Kyriakopoulos, Christos E. Tsao, Che‐Kai Appleman, Leonard J. Gartrell, Benjamin A. Hussain, Arif Stadler, Walter M. Agarwal, Neeraj Pachynski, Russell K. Hutson, Thomas E. Hammers, Hans J. Ryan, Christopher W. Inman, Brant A. Mardekian, Jack Borham, Azah George, Daniel J. |
author_sort | Harrison, Michael R. |
collection | PubMed |
description | 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 χ(2) 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. |
format | Online Article Text |
id | pubmed-8251950 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-82519502021-07-07 Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) Harrison, Michael R. Costello, Brian A. Bhavsar, Nrupen A. Vaishampayan, Ulka Pal, Sumanta K. Zakharia, Yousef Jim, Heather S. L. Fishman, Mayer N. Molina, Ana M. Kyriakopoulos, Christos E. Tsao, Che‐Kai Appleman, Leonard J. Gartrell, Benjamin A. Hussain, Arif Stadler, Walter M. Agarwal, Neeraj Pachynski, Russell K. Hutson, Thomas E. Hammers, Hans J. Ryan, Christopher W. Inman, Brant A. Mardekian, Jack Borham, Azah George, Daniel J. Cancer Original Articles 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 χ(2) 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. John Wiley and Sons Inc. 2021-03-25 2021-07-01 /pmc/articles/PMC8251950/ /pubmed/33765337 http://dx.doi.org/10.1002/cncr.33494 Text en © 2021 The Authors. Cancer published by Wiley Periodicals LLC on behalf of American Cancer Society. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made. |
spellingShingle | Original Articles Harrison, Michael R. Costello, Brian A. Bhavsar, Nrupen A. Vaishampayan, Ulka Pal, Sumanta K. Zakharia, Yousef Jim, Heather S. L. Fishman, Mayer N. Molina, Ana M. Kyriakopoulos, Christos E. Tsao, Che‐Kai Appleman, Leonard J. Gartrell, Benjamin A. Hussain, Arif Stadler, Walter M. Agarwal, Neeraj Pachynski, Russell K. Hutson, Thomas E. Hammers, Hans J. Ryan, Christopher W. Inman, Brant A. Mardekian, Jack Borham, Azah George, Daniel J. Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) |
title | Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) |
title_full | Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) |
title_fullStr | Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) |
title_full_unstemmed | Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) |
title_short | Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC) |
title_sort | active surveillance of metastatic renal cell carcinoma: results from a prospective observational study (marcc) |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8251950/ https://www.ncbi.nlm.nih.gov/pubmed/33765337 http://dx.doi.org/10.1002/cncr.33494 |
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