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      Improving survival in metastatic renal cell carcinoma (mRCC) patients: do elderly patients benefit from expanded targeted therapeutic options?


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          Treatment advances in metastatic renal cell carcinoma (mRCC) have improved overall survival (OS) in mRCC patients over the last two decades. This single center retrospective analysis assesses if the purported survival benefits are also applicable in elderly mRCC patients.


          401 patients with mRCC treated at Hannover Medical School from 01/2003–05/2016 were identified and evaluated by chart review. Treatment periods were defined as 01.01.2003–31.12.2009 (P1) and 01.01.2010–31.05.2016 (P2). Age groups were defined according to WHO classes (≤ 60 years: younger, > 60–75 years: elderly and > 75 years: old). Descriptive statistics, Kaplan–Meier analysis and logistic regression were performed.


          Median OS improved from 35.1 months in P1 to 59.1 months in P2. Sub-division into the respective age groups revealed median survival of 38.1 (95%-CI: 28.6–47.6) months in younger patients, 42.9 (95%-CI: 29.5–56.3) months among elderly patients and 27.3 (95%-CI: 12.8–41.8) months among old patients. Risk reduction for death between periods was most evident among old patients (young: HR 0.71 (95%-CI: 0.45–1.13, p = 0.2); elderly: HR 0.62 (95%-CI: 0.40–0.97, p = 0.04); old: HR 0.43 (95%-CI: 0.18–1.05, p = 0.06)). Age ≥ 75 years was an independent risk factor for death in P1 but not in P2.


          Improved OS in the targeted treatment period was confirmed. Surprisingly elderly and old patients seem to profit the most form expansion of therapeutic armamentarium, within the TKI-dominated observation period.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s00345-022-04110-3.

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                Author and article information

                World J Urol
                World J Urol
                World Journal of Urology
                Springer Berlin Heidelberg (Berlin/Heidelberg )
                2 August 2022
                2 August 2022
                : 40
                : 10
                : 2489-2497
                [1 ]GRID grid.10423.34, ISNI 0000 0000 9529 9877, Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, , Hannover Medical School, ; Hannover, Germany
                [2 ]Comprehensive Cancer Center Lower Saxony, Hannover, Germany
                [3 ]GRID grid.489540.4, ISNI 0000 0001 0656 7508, Interdisciplinary Working Group Renal Cell Cancer of German Cancer Society (IAG-N), ; Berlin, Germany
                [4 ]GRID grid.410718.b, ISNI 0000 0001 0262 7331, Clinic for Internal Medicine (Tumor Research) and Clinic for Urology, , Interdisciplinary Genitourinary Oncology at the West-German Cancer Center, Essen University Hospital, ; Essen, Germany
                [5 ]GRID grid.10423.34, ISNI 0000 0000 9529 9877, Department for Hematology, Hemostaseology, Oncology and Stem Cell Transplantation, , Hannover Medical School, ; OE 6860, Carl-Neuberg Str. 1, Hannover, Germany
                © The Author(s) 2022

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                Funded by: Medizinische Hochschule Hannover (MHH) (3118)
                Original Article
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                © Springer-Verlag GmbH Germany, part of Springer Nature 2022

                renal cell cancer,cytokine,tyrosine kinase inhibition,metastases,age,geriatric patients
                renal cell cancer, cytokine, tyrosine kinase inhibition, metastases, age, geriatric patients


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