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 (M1) and the elderly (aged≥75y). RESULTS:A total of 4,217 patients with mRCC were identified, including 1,533 patients with M1 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.<75y): 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, M1, and elderly populations. CONCLUSION:This real-world study showed continued significant improvement in mRCC OS during the late TT era, including in M1 and elderly populations. TT should be considered for all patients with mRCC based on tolerability, regardless of age.

译文

背景:这项回顾性研究调查了瑞典转移性肾细胞癌(mRCC)患者在治疗前(2002-2005),早期(2006-2008)和晚期(2009-2012)的总生存(OS)和影响OS的因素。靶向治疗(TT)时代。
方法:瑞典的三个国家登记册确定了mRCC患者。中位数操作系统是使用Kaplan-Meier方法估算的。使用Cox比例风险回归进行多变量分析。对同步转移患者(M1)和老年人(年龄≥75岁)进行亚组分析。
结果:共鉴定出4,217例mRCC患者,其中1,533例M1患者和1,275例老年患者。对于2002年至2005年,2006年至2008年以及2009年至2012年诊断为mRCC的患者,中位OS​​为10.0、13.0和18.0个月。同样,M1和老年人口的OS中位数有所改善。老年患者接受TT的可能性较小(≥75vs. <75y):18.3 vs. 63.5%(在2006-2008年)和28.6%vs. 55.9%(在2009-2012年)。 2009年至2012年,对mRCC的诊断,肾切除术和TT处方与总mRCC,M1和老年人口的OS改善相关。
结论:这项现实世界的研究表明,在TT时代后期,包括M1和老年人群,mRCC OS持续显着改善。对于所有mRCC患者,无论年龄大小,均应考虑TT。

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