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    106327-134

Outcomes of patients with sarcomatoid renal cell carcinoma: The Mayo
Clinic experience.

Meeting:
2013 Genitourinary Cancers Symposium

Category:Genitourinary Cancer

Subcategory: Renal Cell Cancer
Session Type and Session Title: 

General Poster Session C: Renal Cancer

Abstract Number: 359

Citation: J Clin Oncol 31, 2013 (suppl 6; abstr 359)

Author(s): 

Brian Addis Costello, Ben Zhang, Christine M. Lohse, Stephen A.
Boorjian, John Cheville, Bradley C. Leibovich, Robert Houston Thompson;
Mayo Clinic, Rochester, MN

*Background: * Sarcomatoid renal cell carcinoma (RCC) is an aggressive
form of RCC and is associated with a poor prognosis. Standard therapies
tend to be less effective in this subset of patients. 

*Methods: * Using the Mayo Clinic Nephrectomy Registry, 206 patients with sarcomatoid RCC
treated with partial or radical nephrectomy were identified. These 
patients were characterized based on extent of disease, treatment
response and survival. 

*Results: * Of these 206, there was no evidence
of distant metastases in 110 patients at the time of surgery and the
estimated distant metastases-free survival at one year was 44%. The
estimated cancer-specific survival rate at one and five years was 56%
and 20%, respectively.
 Compared to patients with grade 4 RCC without
sarcomatoid features, those with sarcomatoid RCC were more likely to
develop distant metastases following surgery (hazard ratio 1.49).
Considering those with metastatic sarcomatoid RCC, 96 patients had
metastases at the time of surgery and 77 with no metastases at the time
of surgery subsequently developed distant metastases (n=173). Of these,
156 died at a mean of 1.0 years from time of first evidence of distant
metastases with a median cancer-specific survival of 0.6 years.
Estimated cancer-specific survival rates from time of first metastases
at one year and five years were 34% and 4%, respectively. The most
common metastatic sites: lung (46%), bone (15%), liver (13%),
non-regional lymph nodes (9%), and brain (5%). 
Patients who received
targeted systemic therapy (10%) with either sunitinib (n=14), sorafenib
(2) or pazopanib (1) for their first occurrence of distant metastases
had an estimated cancer-specific survival rate at one year of 69%,
compared to 30% for patients who did not. Median cancer-specific
survival for those receiving targeted therapy as first-line was 2.2
years compared to 0.6 years for those patients who did not.

*Conclusions: * Sarcomatoid RCC is an aggressive subtype of kidney
cancer as evidenced by poor survival rates. The patients in this
registry with metastatic sarcomatoid RCC who received targeted therapy
as first-line treatment had improved cancer-specific survival rates.

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*Source URL:* http://meetinglibrary.asco.org/content/106327-134
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