Metastazavusiu inkstų vėžiu sergančių pacientų charakteristikos, gydymo metodų pasirinkimas ir jų įtaka išgyvenamumui: 2023–2024 m. LSMUL Kauno klinikų patirtis

Darbą atliko: Agnė Talačkaitė Darbo pavadinimas: Metastazavusiu inkstų vėžiu sergančių pacientų charakteristikos, gydymo metodų pasirinkimas ir jų įtaka išgyvenamumui: 2023–2024 m. LSMUL Kauno klinikų patirtis Darbo tikslas: Įvertinti metastazavusiu inkstų vėžiu sergančių pacientų klinikines ir demografines charakteristikas, analizuoti taikytus gydymo metodus ir nustatyti jų sąsają su pacientų išgyvenamumu. Darbo uždaviniai: 1. Apibūdinti metastazavusiu inkstų vėžiu sergančių pacientų demografines ir klinikines charakteristikas. 2. Išanalizuoti taikytus gydymo metodus pacientams, sergantiems metastazavusiu inkstų vėžiu. 3. Įvertinti skirtingų gydymo metodų, taikomų metastazavusiam inkstų vėžiui gydyti, įtaką pacientų išgyvenamumui. Tyrimo metodai: tyrimas atliktas taikant retrospektyviosios analizės metodą. Vertinti nuasmeninti 74 pacientų, kuriems 2023-2024 m. diagnozuotas metastazavęs inkstų vėžys, duomenys iš LSMUL KK elektroninių sistemų ir ligos istorijų. Analizuoti demografiniai rodikliai, klinikiniai duomenys, išgyvenamumo trukmė. Viso tyrimo metu buvo užtikrintas tiriamųjų konfidencialumas, rezultatai yra skelbiami tik apibendrinti. Statistinė analizė atlikta naudojantis IBM SPSS Statistics 30.0, Microsoft Excel 2016 programinėmis įrangomis. Bendras išgyvenamumas vertintas Kaplan-Meier metodu, grupės lygintos log-rank (Mantel-Cox) testu, o gydymo metodų sąsajai su išgyvenamumu vertinti atlikta vienmatė ir daugiamatė Cox regresijos analizės, rezultatus pateikiant kaip santykinę riziką (SR) su 95 % pasikliautinaisiais intervalais (PI). Gauti rezultatai buvo vertinami statistiškai reikšmingais, kai p < 0,05. Tyrimo dalyviai: 74 pacientai, kurie 2023 – 2024 m. LSMUL KK Onkologijos ir hematologijos klinikoje buvo gydyti dėl metastazavusio inkstų naviko. Tyrimo rezultatai: 1. Metastazavusiu inkstų vėžiu sergančių pacientų vidutinis amžius buvo 64,04 metai, dauguma vyrai, ≥ 60 metų. Dažniausias inkstų ląstelių naviko tipas - šviesių ląstelių karcinoma. Dažniausiai nustatyta cT3 stadija, cN0 kategorija, cM1 liga ir G2 diferenciacijos laipsnis. Daugiausia pacientų priklausė ECOG 0-1 grupėms, o dažniausiai nustatyta IMDC prognostinė grupė buvo vidutinės rizikos. Dažniausios metastazių lokalizacijos – plaučiai, limfmazgiai bei kaulai. 2. Visiems pacientams buvo taikytas I eilės sisteminis gydymas, dažniausiai skiriant sunitinibo arba kabozantinibo monoterapiją. Pirminio naviko operacija atlikta daugiau nei pusei tiriamųjų, metastazių gydyme dažniausiai taikyta ST. 3. Pirminio naviko operacija prieš naviko metastazių diagnozavimą (metastazės išsivystė metachroniškai) buvo susijusi su ilgesniu bendru išgyvenamumu (p = 0,047). Kiti gydymo metodai – pirminio naviko operacija po metastazių nustatymo, II eilės sisteminis gydymas, spindulinė metastazių terapija ir metastazektomija – statistiškai reikšmingos įtakos bendram išgyvenamumui neturėjo (p > 0,05).

Author: Agnė Talačkaitė Research title: Patient Characteristics, Treatment Choices, and the Impact of Treatment Modalities on Survival in Metastatic Kidney Cancer: The 2023-2024 Experience of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics. Research aim: To evaluate the clinical and demographic characteristics of patients with metastatic renal cancer, analyze the treatment methods and determine their association with patient survival. Research objectives: 1. To describe the demographic and clinical characteristics of patients with metastatic renal cancer. 2. To analyze the treatment methods applied to patients with metastatic renal cancer. 3. To evaluate the impact of different treatment methods used for metastatic kidney cancer on overall patient survival. Research methods: the study was done using a retrospective analysis method. Anonymized data from 74 patients diagnosed with metastatic renal cancer in 2023-2024 were collected from the electronic systems and medical records of LHUS Kaunas Clinics. Demographic, clinical and overall survival data were analyzed. Throughout the study, patients confidentiality was secured and no personal information was published. Statistical analysis was performed using IBM SPSS Statistics version 30.0 and Microsoft Excel 2016 software. Overall survival was estimated using the Kaplan-Meier method and survival curves between groups were compared using the log-rank (Mantel-Cox) test. The association between treatment methods and overall survival was assessed using univariate and multivariate Cox proportional hazards regression analyses, with results presented as hazard ratios (HR) and 95 % confidence intervals (Cl). P – value < 0.05 was considered statistically significant. Research participants: 74 patients who were treated for metastatic renal cancer at the Oncology and Hematology Clinic of LHUS Kaunas Clinics in 2023 – 2024. Research results: 1. The mean age of patients with metastatic renal cell carcinoma was 64.04 years, with most patients bein men aged ≥ 60 years. The most common histological tumor type was clear cell renal cell carcinoma. The most common tumor characteristics were cT3 stage, cN0 category, cM1 disease and G2 differentiation. Most patients belonged to ECOG 0-1 and intermediate-risk IMDC group. The most common sites of metastases were the lungs, lymph nodes and bones. 2. All patients received first-line systemic therapy, most commonly sunitinib or cabozantinib monotherapy. Surgery of the primary tumor was performed in more than half of the patients, while treatment of metastases was less frequent and most commonly involved radiotherapy. 3. Surgery of the primary tumor before metastatic diagnosis (metastases developed metachronously) was associated with longer overall survival (p = 0.047). Other treatment methods – primary tumor surgery after the diagnosis of metastases, second-line systemic therapy, radiotherapy for metastases and metastasectomy – had no statistically significant impact on overall survival (p > 0.05).

Author: Agnė Talačkaitė Research title: Patient Characteristics, Treatment Choices, and the Impact of Treatment Modalities on Survival in Metastatic Kidney Cancer: The 2023-2024 Experience of the Hospital of Lithuanian University of Health Sciences Kaunas Clinics. Research aim: To evaluate the clinical and demographic characteristics of patients with metastatic renal cancer, analyze the treatment methods and determine their association with patient survival. Research objectives: 1. To describe the demographic and clinical characteristics of patients with metastatic renal cancer. 2. To analyze the treatment methods applied to patients with metastatic renal cancer. 3. To evaluate the impact of different treatment methods used for metastatic kidney cancer on overall patient survival. Research methods: the study was done using a retrospective analysis method. Anonymized data from 74 patients diagnosed with metastatic renal cancer in 2023-2024 were collected from the electronic systems and medical records of LHUS Kaunas Clinics. Demographic, clinical and overall survival data were analyzed. Throughout the study, patients confidentiality was secured and no personal information was published. Statistical analysis was performed using IBM SPSS Statistics version 30.0 and Microsoft Excel 2016 software. Overall survival was estimated using the Kaplan-Meier method and survival curves between groups were compared using the log-rank (Mantel-Cox) test. The association between treatment methods and overall survival was assessed using univariate and multivariate Cox proportional hazards regression analyses, with results presented as hazard ratios (HR) and 95 % confidence intervals (Cl). P – value < 0.05 was considered statistically significant. Research participants: 74 patients who were treated for metastatic renal cancer at the Oncology and Hematology Clinic of LHUS Kaunas Clinics in 2023 – 2024. Research results: 1. The mean age of patients with metastatic renal cell carcinoma was 64.04 years, with most patients bein men aged ≥ 60 years. The most common histological tumor type was clear cell renal cell carcinoma. The most common tumor characteristics were cT3 stage, cN0 category, cM1 disease and G2 differentiation. Most patients belonged to ECOG 0-1 and intermediate-risk IMDC group. The most common sites of metastases were the lungs, lymph nodes and bones. 2. All patients received first-line systemic therapy, most commonly sunitinib or cabozantinib monotherapy. Surgery of the primary tumor was performed in more than half of the patients, while treatment of metastases was less frequent and most commonly involved radiotherapy. 3. Surgery of the primary tumor before metastatic diagnosis (metastases developed metachronously) was associated with longer overall survival (p = 0.047). Other treatment methods – primary tumor surgery after the diagnosis of metastases, second-line systemic therapy, radiotherapy for metastases and metastasectomy – had no statistically significant impact on overall survival (p > 0.05).