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

dc.contributor.author

Harrison, Michael R

dc.contributor.author

Costello, Brian A

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Bhavsar, Nrupen A

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Vaishampayan, Ulka

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Pal, Sumanta K

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Zakharia, Yousef

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Jim, Heather SL

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Fishman, Mayer N

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Molina, Ana M

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Kyriakopoulos, Christos E

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Tsao, Che-Kai

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Appleman, Leonard J

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Gartrell, Benjamin A

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Hussain, Arif

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Stadler, Walter M

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Agarwal, Neeraj

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Pachynski, Russell K

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Hutson, Thomas E

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Hammers, Hans J

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Ryan, Christopher W

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Inman, Brant A

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Mardekian, Jack

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Borham, Azah

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George, Daniel J

dc.date.accessioned

2022-01-02T19:59:16Z

dc.date.available

2022-01-02T19:59:16Z

dc.date.issued

2021-07

dc.date.updated

2022-01-02T19:59:15Z

dc.description.abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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

0008-543X

dc.identifier.issn

1097-0142

dc.identifier.uri

https://hdl.handle.net/10161/24173

dc.language

eng

dc.publisher

Wiley

dc.relation.ispartof

Cancer

dc.relation.isversionof

10.1002/cncr.33494

dc.subject

active surveillance

dc.subject

metastatic

dc.subject

observational study

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renal cell carcinoma

dc.title

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

dc.type

Journal article

duke.contributor.orcid

Harrison, Michael R|0000-0003-3776-8892

duke.contributor.orcid

Inman, Brant A|0000-0002-6060-4485

pubs.begin-page

2204

pubs.end-page

2212

pubs.issue

13

pubs.organisational-group

School of Medicine

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Duke Cancer Institute

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Medicine, Medical Oncology

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Duke

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Institutes and Centers

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Medicine

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Clinical Science Departments

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Surgery, Urology

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Surgery

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Biostatistics & Bioinformatics

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Duke Science & Society

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Medicine, General Internal Medicine

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Basic Science Departments

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Initiatives

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Institutes and Provost's Academic Units

pubs.publication-status

Published

pubs.volume

127

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