Prognostic Factors in De Novo Metastatic Renal Cell Carcinoma: A Report From the Latin American Renal Cancer Group

Diego Abreu, Gustavo Carvalhal, Guillermo Gueglio, Ignacio Tobia, Patricio Garcia, Alvaro Zuñiga, Luis Meza, Rubén Bengió, Carlos Scorticati, Ricardo Castillejos, Francisco Rodriguez, Ana María Autran, Carmen Gonzales, Jose Gadu, Alejandro Nolazco, Carlos Ameri, Hamilton Zampolli, Raúl Langenhin, Diego Muguruza, Marcos Tobías MachadoPablo Mingote, Juan Yandian, Jorge Clavijo, Lucas Nogueira, Omar Clark, Fernando Secin, Agustín Rovegno, Ana Vilas, Enrique Barrios, Ricardo Decia, Gustavo Guimarães, Sidney Glina, Sumanta K. Pal, Oscar Rodriguez, Joan Palou, Philippe Spiess, Primo N. Lara, W. Marston Linehan, Antonio Luigi Pastore, Stenio C. Zequi

Research output: Contribution to journalArticlepeer-review


PURPOSE: To assess the effect of clinical and pathological variables on cancer-specific and overall survival (OS) in de novo metastatic patients from a collaborative of primarily Latin American countries. PATIENTS AND METHODS: Of 4,060 patients with renal cell carcinoma diagnosed between 1990 and 2015, a total of 530 (14.5%) had metastasis at clinical presentation. Relationships between clinical and pathological parameters and treatment-related outcomes were analyzed by Cox regression and the log-rank method. RESULTS: Of 530 patients, 184 (90.6%) had died of renal cell carcinoma. The median OS of the entire cohort was 24 months. American Society of Anesthesiology classification 3-4 (hazard ratio [HR]: 1.64), perirenal fat invasion (HR: 2.02), and ≥ 2 metastatic organ sites (HR: 2.19) were independent prognostic factors for 5-year OS in multivariable analyses. We created a risk group stratification with these variables: no adverse risk factors (favorable group), median OS not reached; one adverse factor (intermediate group), median OS 33 months (HR: 2.04); and two or three adverse factors (poor risk group), median OS 14 months (HR: 3.58). CONCLUSION: Our study defines novel prognostic factors that are relevant to a Latin American cohort. With external validation, these easily discerned clinical variables can be used to offer prognostic information across low- and middle-income countries.

Original languageEnglish (US)
Pages (from-to)671-685
Number of pages15
JournalJCO Global Oncology
StatePublished - May 1 2021

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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