J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Original Article

Volume 9, Number 4, April 2017, pages 281-288

A Three-Variable Model Predicts Short Survival in Patients With Newly Diagnosed Metastatic Renal Cell Carcinoma

Figure 2. Actuarial overall survival stratified by a three-variable prognostic score. Median survival was 28.0, 18.4, 6.6 and 3.0 months, respectively (P = 0.0001, log-rank test pooled over all strata). Numbers of patients in the four groups were 20, 21, 14, and 3.

**Table 1.** Baseline Characteristics in 60 Patients With Metastatic Renal Cell Carcinoma
Baseline characteristics	n	%
No. of patients	60	100
Gender
Male	40	66.7
Female	20	33.3
Age at metastatic disease
< 60 years	2	3.3
60 - 69	35	58.3
70 - 79	10	16.6
80 - 89	12	20.0
90+	1	1.7
Histology
Unknown	8	13.3
Clear cell	42	70.0
Papillary	5	8.3
Sarcomatoid	2	3.3
Chromofobic	3	5.0
Nephrectomy
No	21	35.0
Yes	39	65.0
Distant metastases at first cancer diagnosis
Yes (synchronous)	42	70.0
No (metachronous)	18	30.0
Initial sites of distant metastases
Bone	34	56.6
Lung	29	48.3
Lymph node	12	20.0
Liver	10	16.6
Skin	2	3.3
Brain	16	26.6
Time interval from first cancer diagnosis to distant metastases
< 1 year	43	71.7
1 - 5 years	10	16.7
> 5 years	7	11.7
Number of metastatic sites
1, for example bone only	16	26.7
2, for example brain and lung	21	35.0
3 or more	23	38.3
Systemic treatment
Yes	34	56.6
No	26	43.3
Sunitinib vs. others
Sunitinib	22	36.6
Pazopanib/temsirolimus/everolimus	12	20.0
ECOG performance status
0 - 1	18	30.0
2	30	50.0
3	12	20.0
Smoking
Yes	34	56.7
No	16	26.7
Unknown	10	16.7
Comorbidity
Heart condition	39	65.0
Diabetes mellitus	7	11.7
Hypercholesterolemia	4	6.7
Unknown	10	16.7
Symptoms at first contact
Hematuria	12	20.0
Bone pain/fracture	16	26.7
Flank pain	5	8.3
Weight loss	14	23.3
Accidental finding	13	21.7
Memorial Sloan Kettering Cancer Center (MSKCC) prognostic group
Good	11	18.3
Intermediate	28	46.7
Poor	20	33.3
Unknown	1	1.7

Table 1. Baseline Characteristics in 60 Patients With Metastatic Renal Cell Carcinoma

Baseline characteristics

No. of patients

100

Gender

Male

66.7

Female

33.3

Age at metastatic disease

< 60 years

3.3

60 - 69

58.3

70 - 79

16.6

80 - 89

20.0

90+

1.7

Histology

Unknown

13.3

Clear cell

70.0

Papillary

8.3

Sarcomatoid

3.3

Chromofobic

5.0

Nephrectomy

35.0

Yes

65.0

Distant metastases at first cancer diagnosis

Yes (synchronous)

70.0

No (metachronous)

30.0

Initial sites of distant metastases

Bone

56.6

Lung

48.3

Lymph node

20.0

Liver

16.6

Skin

3.3

Brain

26.6

Time interval from first cancer diagnosis to distant metastases

< 1 year

71.7

1 - 5 years

16.7

> 5 years

11.7

Number of metastatic sites

1, for example bone only

26.7

2, for example brain and lung

35.0

3 or more

38.3

Systemic treatment

Yes

56.6

43.3

Sunitinib vs. others

Sunitinib

36.6

Pazopanib/temsirolimus/everolimus

20.0

ECOG performance status

0 - 1

30.0

50.0

20.0

Smoking

Yes

56.7

26.7

Unknown

16.7

Comorbidity

Heart condition

65.0

Diabetes mellitus

11.7

Hypercholesterolemia

6.7

Unknown

16.7

Symptoms at first contact

Hematuria

20.0

Bone pain/fracture

26.7

Flank pain

8.3

Weight loss

23.3

Accidental finding

21.7

Memorial Sloan Kettering Cancer Center (MSKCC) prognostic group

Good

18.3

Intermediate

46.7

Poor

33.3

Unknown

1.7

**Table 2.** Pretreatment Blood Tests
Parameter	n	%
Low hemoglobin	33	55.0
Lactate dehydrogenase > 1.5 time upper limit of normal	4	6.7
Lactate dehydrogenase ≥ 210 U/L	10	16.7
Glasgow prognostic score 0 (normal C-reactive protein and albumin)	11	18.3
Glasgow prognostic score 1	36	60.0
Glasgow prognostic score 2 (abnormal C-reactive protein and albumin)	12	20.0
Glasgow prognostic score unknown	1	1.7

Table 2. Pretreatment Blood Tests

Parameter

Low hemoglobin

55.0

Lactate dehydrogenase > 1.5 time upper limit of normal

6.7

Lactate dehydrogenase ≥ 210 U/L

16.7

Glasgow prognostic score 0 (normal C-reactive protein and albumin)

18.3

Glasgow prognostic score 1

60.0

Glasgow prognostic score 2 (abnormal C-reactive protein and albumin)

20.0

Glasgow prognostic score unknown

1.7

**Table 3.** Association Between Baseline Parameters and Survival Outcome (Parameters With P-Value > 0.3 Not Shown)
Parameter	Patients who died within about 3 months (%)	P-value
Systemic treatment	5.9
No systemic treatment	32.0	0.008
Interval between first cancer diagnosis and distant metastases < 1 year	20.5
Longer interval	6.7	0.27
Skin metastases	50.0
No skin metastases	14.5	0.07
Nephrectomy	13.2
No nephrectomy	25.0	0.26
Hemoglobin < 12 g/dL	28.0
Hemoglobin ≥ 12 g/dL	9.1	0.05
Lactate dehydrogenase ≥ 210 U/L	44.4
Lactate dehydrogenase < 210 U/L	12.0	0.017

Table 3. Association Between Baseline Parameters and Survival Outcome (Parameters With P-Value > 0.3 Not Shown)

Parameter

Patients who died within about 3 months (%)

P-value

Systemic treatment

5.9

No systemic treatment

32.0

0.008

Interval between first cancer diagnosis and distant metastases < 1 year

20.5

Longer interval

6.7

0.27

Skin metastases

50.0

No skin metastases

14.5

0.07

Nephrectomy

13.2

No nephrectomy

25.0

0.26

Hemoglobin < 12 g/dL

28.0

Hemoglobin ≥ 12 g/dL

9.1

0.05

Lactate dehydrogenase ≥ 210 U/L

44.4

Lactate dehydrogenase < 210 U/L

12.0

0.017