Effect of prognostic factors on survival rates in patients with non-clear cell renal cell carcinoma

Currently, there is a need to search for new prognostic factors in patients with non-clear cell renal cell carcinoma (nccRCC) for personalized therapy to improve survival rates. Objective: To study the most important prognostic factors influencing survival rates in patients with nccRCC. Material and methods. A retrospective analysis of the data of 114 patients with nccRCC treated at the Moscow City Oncologic Hospital No. 62 in Moscow and the City Clinical Oncology Center (St. Petersburg) from 2006 to 2022 was carried out. Papillary cancer was detected in 46 (40.3 %) patients, chromophobe cancer in 19 (16.7 %) and sarcomotoid cancer in 49 (43 %) patients. Seventy-four (64.9 %) patients had an unfavourable prognosis according to international RCC Data Base Consortium, with low-differentiated tumors in 72 (63.2 %) patients. Multiple metastases were detected in 88 (77.2 %) patients. The study investigated clinical and morphologic prognostic factors influencing survival rates in nccRCC patients. Results. The 3- and 5-year overall survival (OS) rates in nccRCC patients were 27 % [95 % ci 20–37 %] and 10 % [95 % CI 5–18 %], respectively. Univariate analysis in patients with nccRCC revealed that survival was negatively affected by tumor histological subtype (p<0.001), ECOG performance status (p=0.048), Fuhrman tumor differentiation grade (p<0.001), number of metastases (p=0.019), liver metastases (p=0.012) and lymph node metastases (p<0.001), hemoglobin (p<0.001), alkaline phosphatase (p<0.001), lactate dehydrogenase (LDH) (p=0.005), platelets (p<0.001), and ESR (p<0.001) levels, as well as metastasectomy (p=0.033). in multivariate analysis, age older than 75 years (p=0.041), tumor histological subtype (p=0.015), type of metastases (p=0.049), liver (p=0.011) and lymph node (p=0.026) metastases, and hemoglobin level (p=0.001) were additional factors affecting the OS in patients with nccRCC. Conclusion. The prognostic factors, such as age over 75 years, type of metastases, metastases to liver, lymph nodes, and hemoglobin level, may provide a personalized approach to comprehensive treatment and evaluation of survival rates in patients with nccRCC.

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