Prognostic factors for survival in metastatic renal cell carcinoma: a single centre retrospective study

Owing to its resistance to chemotherapy, radiotherapy and hormonal therapy, very few treatment options were once available for patients affected by renal cell carcinoma. Nowadays, on the contrary, thanks to the discovery of effective targeted therapies and immunotherapies in the past decades, the treatment options are numerous, and constantly evolving. This prompted the need for updating current prognostic systems, so as to obtain universally valid, prognostic and predictive models for patients with mRCC treated with novel molecules. Our single centre retrospective study assessed the prognostic value of various factors, among which the presence of sarcomatoid features, presence of brain metastases, and BMI ≥ 25kg/m2, in a sample of 343 metastatic RCC patients who had undergone loco-regional and/or systemic therapy for metastatic disease. All three factors were confirmed to have independent prognostic significance in RCC at multivariate analysis, with hazard ratios of 1.52 (95% CI 1.17–1.98, p=0.0019), 2.75 (95% CI 1.60–4.70, p=0.0002), 0.76 (95% CI 0.60–0.96, p=0.0211), respectively. Based on these results, together with the literary evidence suggesting a potential predictive role of sarcomatoid features and BMI in the setting of immune checkpoint inhibitor therapy, we believe that these three factors could be useful in the future to develop and validate a clinicopathological prognostic model for predicting survival in metastatic renal cell carcinoma.