Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC).
Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC).
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DOI：
10.1002/cncr.33494
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发表时间：
2021-07-01
期刊：
影响因子：
6.2
通讯作者：
George DJ
中科院分区：
文献类型：
--
作者：
Harrison MR;Costello BA;Bhavsar NA;Vaishampayan U;Pal SK;Zakharia Y;Jim HSL;Fishman MN;Molina AM;Kyriakopoulos CE;Tsao CK;Appleman LJ;Gartrell BA;Hussain A;Stadler WM;Agarwal N;Pachynski RK;Hutson TE;Hammers HJ;Ryan CW;Inman BA;Mardekian J;Borham A;George DJ
在患有转移性肾细胞癌（mRCC）和缓慢生长转移的患者中，可以推迟全身治疗（ST）。目前，这部分患者接受主动监测（AS）治疗的情况在文献中没有得到很好的描述。这是一项在46个美国社区和学术中心的mRCC患者中进行的前瞻性观察性研究。目的是描述最初接受AS治疗的mRCC患者的基线特征和人口统计学资料、AS的原因和患者结局。使用描述性统计量描述人口统计学、基线特征和患者相关结局。分别使用Wilcoxon双样本秩和检验和χ2检验评估ST和AS队列之间连续变量和分类变量的差异。Kaplan-Meier生存曲线用于评估生存率。在504例患者中，mRCC最初通过AS（n = 143）或ST（n = 305）进行治疗; 56例患者从分析中排除。接受AS治疗的患者中有69%存在疾病，而其余31%没有疾病证据。在数据截止时，143例AS患者中有72例（50%）未接受ST治疗，未达到中位总生存期（95% CI，122个月至不可估计），接受AS的患者vs 30个月（95%可信区间，25 - 44个月）在接受ST治疗的患者中，基线时的生活质量在接受AS治疗的患者中明显优于接受ST治疗的患者。在真实的临床实践中，这一比例为32%），在选定患者中似乎是即刻ST的一种安全且适当的替代方法。这项前瞻性观察性研究随访了治疗前通过主动监测管理的转移性肾细胞癌患者。该方法在临床实践中经常使用，对某些患者来说似乎是一种安全和适当的选择。
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. 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. 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. AS occurs frequently (32%) in real‐world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients. This prospective observational study followed patients with metastatic renal cell carcinoma who were managed by active surveillance before treatment. The approach is used frequently in clinical practice and appears to be a safe and appropriate option for some patients.
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DOI：
10.1111/j.1464-410x.1989.tb05147.x
发表时间：
1989-02-01
期刊：
BRITISH JOURNAL OF UROLOGY
影响因子：
--
作者：
OLIVER, RTD;NETHERSELL, ABW;BOTTOMLEY, JM
通讯作者：
BOTTOMLEY, JM
影响因子：
45.3
作者：
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通讯作者：
Ferrara, J
DOI：
10.1016/j.urolonc.2017.05.013
发表时间：
2017-09-01
影响因子：
2.7
作者：
Lindskog, Magnus;Wahlgren, Thomas;Harmenberg, Ulrika
通讯作者：
Harmenberg, Ulrika
影响因子：
2.1
作者：
Matsubara, Nobuaki;Mukai, Hirofumi;Sakai, Yasuyuki
通讯作者：
Sakai, Yasuyuki
DOI：
10.1126/science.aan5951
发表时间：
2018-02-16
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
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通讯作者：
Van Allen EM