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Metastatic renal carcinoma comprehensive prognostic system.

Atzpodien J, Royston P, Wandert T, Reitz M, DGCIN -- German Cooperative Renal Carcinoma Chemo-Immunotherapy Trials Gro - Br. J. Cancer (2003)

Bottom Line: Cox regression analysis with forward stepwise variable selection identified neutrophil count as the major prognostic factor (hazard ratio=1.9, P<0.001), while serum levels of LDH and CRP, time between diagnosis of tumour and onset of metastatic disease, number of metastatic sites, and bone metastases were significant but somewhat less important prognostic variables within the multiple risk factor model (hazard ratio < or = 1.5).Patients were assigned to one of the three risk groups according to cumulative risk defined as the sum of simplified risk s.c.ores for six pretreatment variables.Low-, intermediate-, and high-risk patients achieved a median overall survival of 32+ months (95% CI 24, 43; 5-year survival of 27%), 18+ months (95% CI 15, 20; 5-year survival of 11%), and 8+ months (95% CI 6, 10; 5-year survival of 5%), respectively.

View Article: PubMed Central - PubMed

Affiliation: medizinische Hochschule Hannover, Germany. SekrProAtzpodien@yahoo.de

ABSTRACT
The purpose of the study was to identify a comprehensive prognostic system of pretreatment clinical parameters in 425 patients (pts) with metastatic renal-cell carcinoma treated with different subcutaneous (s.c.) recombinant cytokine-based home therapies in consecutive trials. Treatment consisted of (A) s.c. interferon-alpha 2a (INF-alpha), s.c. interleukin-2 (IL-2) (n=102 pts), (B) s.c. IFN-alpha 2a, s.c. IL-2, and i.v. 5-fluorouracil (5-FU) (n=235 pts) or (C) s.c. IFN-alpha 2a, s.c. IL-2, and i.v. 5-FU combined with p.o. 13-cis-retinoic acid (13cRA) (n=88 pts). Kaplan-Meier survival analysis, log-rank statistics, and Cox regression analysis were employed to identify risk factors and to create a multiple risk factor model. The following pretreatment risk factors were identified by univariate analysis: (1) three and more metastatic sites, (2) presence of liver, lymph node or bone metastases, (3) neutrophil count > or = 6500 cells microl(-1), (4) serum lactate dehydrogenase level (LDH) > or = 220 U l(-1), and (5) serum C-reactive protein level (CRP) > or = 11 mg l(-1). Cox regression analysis with forward stepwise variable selection identified neutrophil count as the major prognostic factor (hazard ratio=1.9, P<0.001), while serum levels of LDH and CRP, time between diagnosis of tumour and onset of metastatic disease, number of metastatic sites, and bone metastases were significant but somewhat less important prognostic variables within the multiple risk factor model (hazard ratio < or = 1.5). Patients were assigned to one of the three risk groups according to cumulative risk defined as the sum of simplified risk s.c.ores for six pretreatment variables. Low-, intermediate-, and high-risk patients achieved a median overall survival of 32+ months (95% CI 24, 43; 5-year survival of 27%), 18+ months (95% CI 15, 20; 5-year survival of 11%), and 8+ months (95% CI 6, 10; 5-year survival of 5%), respectively. These prognostic categories are helpful both in individual patient care and in the assessment of patients entering prospective clinical trials.

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Overall survival of 425 advanced renal-cell carcinoma patients treated with outpatient s.c. IL-2/INF-α2a therapy (A). Overall survival of 163 low-risk patients, 197 intermediate-risk patients, and 65 high-risk patients treated with outpatient subcutaneous interleukin-2/interferon-α2a therapy (B). Survival was calculated from the start of therapy using Kaplan–Meier method.
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fig3: Overall survival of 425 advanced renal-cell carcinoma patients treated with outpatient s.c. IL-2/INF-α2a therapy (A). Overall survival of 163 low-risk patients, 197 intermediate-risk patients, and 65 high-risk patients treated with outpatient subcutaneous interleukin-2/interferon-α2a therapy (B). Survival was calculated from the start of therapy using Kaplan–Meier method.

Mentions: Median survival time was 20+ months (95% CI, 18, 22; 5-year survival of 16%) (Figure 3AFigure 3


Metastatic renal carcinoma comprehensive prognostic system.

Atzpodien J, Royston P, Wandert T, Reitz M, DGCIN -- German Cooperative Renal Carcinoma Chemo-Immunotherapy Trials Gro - Br. J. Cancer (2003)

Overall survival of 425 advanced renal-cell carcinoma patients treated with outpatient s.c. IL-2/INF-α2a therapy (A). Overall survival of 163 low-risk patients, 197 intermediate-risk patients, and 65 high-risk patients treated with outpatient subcutaneous interleukin-2/interferon-α2a therapy (B). Survival was calculated from the start of therapy using Kaplan–Meier method.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2747541&req=5

fig3: Overall survival of 425 advanced renal-cell carcinoma patients treated with outpatient s.c. IL-2/INF-α2a therapy (A). Overall survival of 163 low-risk patients, 197 intermediate-risk patients, and 65 high-risk patients treated with outpatient subcutaneous interleukin-2/interferon-α2a therapy (B). Survival was calculated from the start of therapy using Kaplan–Meier method.
Mentions: Median survival time was 20+ months (95% CI, 18, 22; 5-year survival of 16%) (Figure 3AFigure 3

Bottom Line: Cox regression analysis with forward stepwise variable selection identified neutrophil count as the major prognostic factor (hazard ratio=1.9, P<0.001), while serum levels of LDH and CRP, time between diagnosis of tumour and onset of metastatic disease, number of metastatic sites, and bone metastases were significant but somewhat less important prognostic variables within the multiple risk factor model (hazard ratio < or = 1.5).Patients were assigned to one of the three risk groups according to cumulative risk defined as the sum of simplified risk s.c.ores for six pretreatment variables.Low-, intermediate-, and high-risk patients achieved a median overall survival of 32+ months (95% CI 24, 43; 5-year survival of 27%), 18+ months (95% CI 15, 20; 5-year survival of 11%), and 8+ months (95% CI 6, 10; 5-year survival of 5%), respectively.

View Article: PubMed Central - PubMed

Affiliation: medizinische Hochschule Hannover, Germany. SekrProAtzpodien@yahoo.de

ABSTRACT
The purpose of the study was to identify a comprehensive prognostic system of pretreatment clinical parameters in 425 patients (pts) with metastatic renal-cell carcinoma treated with different subcutaneous (s.c.) recombinant cytokine-based home therapies in consecutive trials. Treatment consisted of (A) s.c. interferon-alpha 2a (INF-alpha), s.c. interleukin-2 (IL-2) (n=102 pts), (B) s.c. IFN-alpha 2a, s.c. IL-2, and i.v. 5-fluorouracil (5-FU) (n=235 pts) or (C) s.c. IFN-alpha 2a, s.c. IL-2, and i.v. 5-FU combined with p.o. 13-cis-retinoic acid (13cRA) (n=88 pts). Kaplan-Meier survival analysis, log-rank statistics, and Cox regression analysis were employed to identify risk factors and to create a multiple risk factor model. The following pretreatment risk factors were identified by univariate analysis: (1) three and more metastatic sites, (2) presence of liver, lymph node or bone metastases, (3) neutrophil count > or = 6500 cells microl(-1), (4) serum lactate dehydrogenase level (LDH) > or = 220 U l(-1), and (5) serum C-reactive protein level (CRP) > or = 11 mg l(-1). Cox regression analysis with forward stepwise variable selection identified neutrophil count as the major prognostic factor (hazard ratio=1.9, P<0.001), while serum levels of LDH and CRP, time between diagnosis of tumour and onset of metastatic disease, number of metastatic sites, and bone metastases were significant but somewhat less important prognostic variables within the multiple risk factor model (hazard ratio < or = 1.5). Patients were assigned to one of the three risk groups according to cumulative risk defined as the sum of simplified risk s.c.ores for six pretreatment variables. Low-, intermediate-, and high-risk patients achieved a median overall survival of 32+ months (95% CI 24, 43; 5-year survival of 27%), 18+ months (95% CI 15, 20; 5-year survival of 11%), and 8+ months (95% CI 6, 10; 5-year survival of 5%), respectively. These prognostic categories are helpful both in individual patient care and in the assessment of patients entering prospective clinical trials.

Show MeSH
Related in: MedlinePlus