The Prognosis and Clinicopathological Features of Different Distant Metastases Pattern in Renal Cell Carcinoma: Analysis Based on SEER Database

Background: Existing data on the prognosis and clinicopathological features of patients with metastatic renal cell carcinoma (mRCC) are limited. This study aims to investigate the prognostic value and clinicopathological features of different metastatic sites in patients with mRCC. Methods: A dataset from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) 18 Registries (1973–2015) was selected for a retrospective mRCC cohort study. There was information on distribution of metastatic lesions in lung, bone, liver, and brain in the SEER database. Kaplan-Meier analysis and nomogram analyses were applied to compare the survival distribution of cases. Univariate and multivariate cox regression models were used to analyze survival outcomes and risk factors. Results: From the SEER database, a total of 10410 patients with primary mRCC from 2010 to 2015 were enrolled in this cohort study. Based on the initial metastatic sites, 54.9%, 37.7%, 19.5%, and 10.4 % of patients were found to have lung, bone, liver, and brain metastasis, respectively. Patients who had a single site of distant metastases accounted for 50.6% (5268/10410). Sarcomatoid RCC had significantly higher risk to develop liver metastasis than clear cell RCC, and liver metastasis had the worst prognosis in all the patients. The median survival for patients with lung, bone, liver, and brain metastasis was 7 months, 7 months, 4 months and 5 months, respectively. The nomogram model was constructed to visually present the 1-, 3- and 5-year survival rates of patients. Conclusion: In conclusion, different metastatic sites possess various clinicopathological features and prognostic values. Understanding these differences may contribute to designing targeted pre-treatment assessment of primary mRCC and creating a personalized curative intervention.