Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC).



Systemic therapy (ST) can be deferred in patients who have metastatic renal cell carcinoma (mRCC) and slow-growing metastases. Currently, this subset of patients managed with active surveillance (AS) is not well described in the literature.


This was a prospective observational study of patients with mRCC across 46 US community and academic centers. The objective was to describe baseline characteristics and demographics of patients with mRCC initially managed by AS, reasons for AS, and patient outcomes. Descriptive statistics were used to characterize demographics, baseline characteristics, and patient-related outcomes. Wilcoxon 2-sample rank-sum tests and χ2 tests were used to assess differences between ST and AS cohorts in continuous and categorical variables, respectively. Kaplan-Meier survival curves were used to assess survival.


Of 504 patients, mRCC was initially managed by AS (n = 143) or ST (n = 305); 56 patients were excluded from the analysis. Disease was present in 69% of patients who received AS, whereas the remaining 31% had no evidence of disease. At data cutoff, 72 of 143 patients (50%) in the AS cohort had not received ST. The median overall survival was not reached (95% CI, 122 months to not estimable) in patients who received AS versus 30 months (95% CI, 25-44 months) in those who received ST. Quality of life at baseline was significantly better in patients who were managed with AS versus ST.


AS occurs frequently (32%) in real-world clinical practice and appears to be a safe and appropriate alternative to immediate ST in selected patients.





Published Version (Please cite this version)


Publication Info

Harrison, Michael R, Brian A Costello, Nrupen A Bhavsar, Ulka Vaishampayan, Sumanta K Pal, Yousef Zakharia, Heather SL Jim, Mayer N Fishman, et al. (2021). Active surveillance of metastatic renal cell carcinoma: Results from a prospective observational study (MaRCC). Cancer, 127(13). pp. 2204–2212. 10.1002/cncr.33494 Retrieved from

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Michael Roger Harrison

Associate Professor of Medicine

Nrupen Bhavsar

Associate Professor in Surgery

I am a quantitative epidemiologist with methodological expertise in the design and analysis of observational studies that leverage data from cohort studies, registries, and the electronic health record (EHR). My background, training, and research is in the measurement and characterization of biomarkers, risk factors and treatment outcomes for chronic disease using real-world datasets. My primary research interests are in the use of novel sources of data, including the EHR, to conduct chronic disease research at the intersection of informatics, biostatistics, and epidemiology. My ongoing work aims to integrate informatics, epidemiology, and biostatistics to reduce the burden of chronic disease. I have topical expertise in multiple chronic diseases, including oncology, cardiovascular disease, and chronic kidney disease. In parallel, I have a portfolio of research that aims to understand the impact of social determinants of health, including dynamic neighborhood changes, such as gentrification, on the health of adults and children. 


Daniel James George

Eleanor Easley Distinguished Professor in the School of Medicine

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