Retrospective analysis of 156 cases of metastatic renal cell carcinoma: Evaluation of prognostic factors and response to different treatments

Background: Metastatic renal cell carcinoma is a 'capricious' tumor. Many prognostic factors have been evaluated, treatment is still controversial, and results are not coincident. Methods: We reviewed 156 patients with metastatic renal cell carcinoma. Survival from the time of diagnosis was the end point of the study. The influence on survival of age, sex, nephrectomy, disease-free interval, performance status, site and number of metastases was analyzed. Univariate and multivariate analysis were done. Survival according to different therapies was also evaluated. Results: In our study, no nephrectomy, a disease-free interval <24 months, > 2 metastatic sites and a performance status > 2 proved to be risk factors. According to the number of risk factors, 3 groups of patients were identified (low, intermediate and high risk). We observed 3 kinds of responses to treatments: 1) in untreated patients (n = 48), median overall survival was 6 months, and the 24-month survival rate was 8%; 2) in patients treated with hormone therapy and/or chemotherapy (n = 73), median overall survival was 13 months, and the 24-month survival rate was 24%; 3) in patients treated with interferon and/or interleukin-2 (n = 35), median overall survival was 16 months and the 24-month survival rate was 34%. Conclusions: Our results are only partially in accordance with those observed by other authors. Risk factors and treatment must be determined in more defined and selected studies.