International Journal of Clinical Oncology最新文献

{"title":"Burden and trajectories of biliary tract malignancies in Taiwan from 1998 to 2022.","authors":"Chung-Hsin Tsai, I-Hung Chien, Shih-Ping Cheng","doi":"10.1007/s10147-025-02841-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02841-y","url":null,"abstract":"<p><strong>Background: </strong>Biliary tract cancers, though relatively rare, exhibit wide variations in incidence rates across countries. We conducted a population-based cohort study to delineate the epidemiological trends over 25 years in Taiwan.</p><p><strong>Methods: </strong>Age-standardized incidence and mortality rates of biliary tract cancers were obtained from the Taiwan Cancer Registry. These cancers were identified using the International Classification of Diseases for Oncology codes C23-C24, which include those originating in the gallbladder and extrahepatic bile ducts while excluding intrahepatic cholangiocarcinomas. The annual percent change (APC) was calculated using joinpoint regression models.</p><p><strong>Results: </strong>Male patients experienced an increasing incidence from 1998 to 2009 (APC = 1.54%) and remained stable thereafter. In contrast, female patients had stable incidence rates from 1998 to 2009, followed by a decrease from 2009 to 2022 (APC = - 1.30%). Age-specific analyses showed that younger generations exhibited a decreasing trend, while the elderly had stable or increasing incidence rates. The proportion of patients receiving surgical treatment declined during the study period, while those undergoing chemotherapy and radiotherapy significantly increased. Mortality rates decreased after 2007.</p><p><strong>Conclusion: </strong>Considerable gender disparities and cohort effects exist in the incidence trends of biliary tract cancers. In addition to surgery, chemotherapy with or without radiation therapy has become an important component of multimodal treatment.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144690115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of cisplatin-based neoadjuvant chemotherapy and risk factors for residual extravesical disease in muscle-invasive bladder cancer: insights from a nationwide cohort.","authors":"Ryoichi Saito, Rikiya Taoka, Jun Miki, Wataru Fukuokaya, Yoshiyuki Matsui, Shingo Hatakeyama, Takashi Kawahara, Ayumu Matsuda, Taketo Kawai, Tomokazu Sazuka, Minoru Kato, Takeshi Sano, Fumihiko Urabe, Soki Kashima, Hirohito Naito, Yoji Murakami, Makito Miyake, Kei Daizumoto, Yuto Matsushita, Takuji Hayashi, Junichi Inokuchi, Yusuke Sugino, Kenichiro Shiga, Noriya Yamaguchi, Shingo Yamamoto, Keiji Yasue, Takashige Abe, Shotaro Nakanishi, Katsuyoshi Hashine, Masato Fujii, Kiyoaki Nishihara, Hiroaki Matsumoto, Shuichi Tatarano, Koichiro Wada, Sho Sekito, Ryo Maruyama, Naotaka Nishiyama, Hiroyuki Nishiyama, Hiroshi Kitamura, Hidefumi Kinoshita","doi":"10.1007/s10147-025-02833-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02833-y","url":null,"abstract":"<p><strong>Background: </strong>Cisplatin-based neoadjuvant chemotherapy (NAC) improves survival in muscle-invasive bladder cancer (MIBC) as long as disease progression does not occur during treatment. However, predictors of NAC sensitivity remain elusive in clinical practice. This study evaluated the efficacy of NAC followed by radical cystectomy (NAC-RC) in cStage II-IIIA MIBC and identified the risk factors associated with residual extravesical disease.</p><p><strong>Methods: </strong>Clinical data from 1474 patients who underwent radical cystectomy for cStage II-IIIA urothelial carcinoma were collected from 36 institutions of the Japanese Urological Oncology Group. Overall survival (OS) and non-urinary tract recurrence-free survival (NUT-RFS) were compared between the NAC-RC and upfront RC groups using the Kaplan-Meier method adjusted by inverse probability of treatment weighting. Logistic regression was used to identify independent risk factors for RED.</p><p><strong>Results: </strong>Pathological complete response (pT0N0) was achieved in 33.1 and 20.2% of cStage II and IIIA patients in the NAC-RC group, respectively, compared with 16.3 and 4.5% in the RC group. NAC significantly improved the OS and NUT-RFS in the IPTW-adjusted cohort. BCG-unresponsiveness, low serum albumin levels, and a high neutrophil-to-lymphocyte ratio were independent predictors of RED in the NAC-RC cohort. Squamous differentiation was associated with worse prognosis but a favorable response to NAC in some tumors.</p><p><strong>Conclusions: </strong>Cisplatin-based NAC improves outcomes in patients with cStage II-IIIA MIBC, including some tumors with squamous differentiation; however, its benefits may be limited in BCG-unresponsive cases. Given the biological heterogeneity of urothelial cancer, individualized treatment planning that integrates biological features and treatment history is needed for patients with MIBC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of pretreatment vascular endothelial growth factor inhibitor use on the safety and efficacy of trifluridine/tipiracil plus bevacizumab in patients with metastatic colorectal cancer.","authors":"Koshiro Fukuda, Hiroki Osumi, Akira Ooki, Daisaku Kamiimabeppu, Shohei Udagawa, Shota Fukuoka, Mariko Ogura, Takeru Wakatsuki, Keisho Chin, Mitsuhiro Fujishiro, Kensei Yamaguchi, Eiji Shinozaki","doi":"10.1007/s10147-025-02831-0","DOIUrl":"https://doi.org/10.1007/s10147-025-02831-0","url":null,"abstract":"<p><strong>Background: </strong>The effect of vascular endothelial growth factor (VEGF) inhibitor pretreatment on clinical outcomes of trifluridine/tipiracil (FTD/TPI) plus bevacizumab (BEV) in patients with metastatic colorectal cancer (mCRC) remains unclear. We aimed to investigate this effect.</p><p><strong>Methods: </strong>Patients with mCRC treated with FTD/TPI plus BEV were retrospectively enrolled. Disease control rate (DCR), progression-free survival (PFS), overall survival (OS), and adverse events (AEs) were compared. In total, 73, 50, and 33 patients were treated with fluorouracil+levofolinate calcium+irinotecan (FOLFIRI) plus BEV, ramucirumab, and aflibercept, respectively.</p><p><strong>Results: </strong>The DCR and median PFS/OS did not significantly differ among the groups (DCR: 54.8% vs. 56.0% vs. 42.4%, P = 0.43; PFS: 3.9 vs. 4.6 vs. 3.7 months, P = 0.45; OS: 12.0 vs. 9.5 vs. 11.9 months, P = 0.28). The most common grade 3-4 AE was neutropenia. The incidence of grade 3-4 AEs did not significantly differ among the groups. The frequency of grade ≥2 proteinuria during FTD/TPI plus BEV treatment was significantly higher in patients with grade ≥2 proteinuria before FOLFIRI plus VEGF inhibitor use than in those without proteinuria. Multivariate analysis revealed poor performance status (ECOG PS) and liver metastasis as independent predictors of short PFS/OS (ECOG PS, PFS: P = 0.021, OS: P < 0.001; liver metastasis, PFS: P = 0.03, OS: P < 0.001) and grade 3-4 neutropenia in a month as a predictor of long PFS/OS (PFS: P = 0.047, OS: P = 0.03).</p><p><strong>Conclusion: </strong>Different pretreatment VEGF inhibitors did not affect the efficacy and safety of FTD/TPI plus BEV.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144674706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in liquid biopsy for bone and soft-tissue sarcomas.","authors":"Yilang Wang, Tomohiro Fujiwara, Takanao Kurozumi, Teruhiko Ando, Takahiko Ishimaru, Hiroya Kondo, Eiji Nakata, Toshiyuki Kunisada, Toshifumi Ozaki","doi":"10.1007/s10147-025-02813-2","DOIUrl":"https://doi.org/10.1007/s10147-025-02813-2","url":null,"abstract":"<p><p>Bone and soft-tissue sarcomas are a heterogeneous group of malignant tumors originating from mesenchymal tissues, accounting for approximately 1% of adult solid malignancies and 20% of pediatric solid malignancies. While blood-based tumor markers are available in major types of cancers, evidence demonstrating useful circulating biomarkers is limited in bone and soft-tissue sarcomas. Despite the development of combined modality treatments, a significant proportion of sarcoma patients respond poorly to chemotherapy or radiotherapy, leading to local relapse or distant metastasis. However, imaging methods, such as X-ray, computed tomography, positron emission tomography, magnetic resonance imaging, and scintigraphy, are mostly used to detect or monitor tumor development. Liquid biopsy is an emerging minimally invasive diagnostic technique that detects tumor-derived molecules in body fluids, including circulating tumor cells, circulating tumor DNA (ctDNA), circulating tumor RNA (ctRNA), and circulating extracellular vesicles. This method offers new possibilities for early tumor detection, prognostic evaluation, and therapeutic monitoring and may serve as a benchmark for treatment modification. This review focuses on the current technological advances in liquid biopsy for bone and soft-tissue sarcoma and explores its potential role in guiding personalized treatments. If these modalities could determine resistance to ongoing therapy or the presence of minimal residual disease at the end of the treatment protocol, the obtained data would be important for determining whether to change treatment approaches or add adjuvant therapies.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The nationwide survey of Japanese public opinion about off-label use of anticancer drugs recommended by comprehensive genomic profiling.","authors":"Junichi Matsubara, Kumi Mukai, Manabu Muto","doi":"10.1007/s10147-025-02809-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02809-y","url":null,"abstract":"<p><strong>Background: </strong>Comprehensive genomic profiling (CGP)-guided precision medicine enables identification of molecular-based recommended therapy (MBRT), including off-label uses of anticancer drugs for rare genomic alterations. However, in Japan, access to such off-label drugs is limited despite their potential therapeutic benefits. This study aimed to investigate public attitudes toward off-label use of anticancer drugs in Japan.</p><p><strong>Methods: </strong>A nationwide online survey was conducted in Japan from February 15 to 19, 2024, targeting cancer patients (CA), medical professionals (MP), and non-cancer volunteers (non-CA) aged 40 + years. This included explanatory materials on CGP and MBRT, and questionnaires assessing willingness to use off-label drugs in various cost scenarios.</p><p><strong>Results: </strong>A total of 1,261 responses were analyzed: 419 CA, 430 MP, and 412 non-CA participants (median age: 59, range 40-89). Approximately 80% of MPs reported high comprehension of the explanatory materials (Top-2 box on a 5-point Likert scale), compared with ~ 60% of CA and < 50% of non-CA participants. Willingness to use off-label drugs (Top-2 box) was as follows: \"No cost burden\": 51% CA, 62% MP, and 50% non-CA; \"Cost ¥200,000 per month (approximately $US1,300)\": 15% CA, 31% MP, and 15% non-CA; \"Cost ¥1,000,000 per month (approximately $US6,700)\": 6% CA, 16% MP, and 4% non-CA. Higher comprehension of explanatory materials was associated with greater willingness to use off-label drugs.</p><p><strong>Conclusions: </strong>Over half of respondents were willing to use off-label anticancer drugs if they were free of charge. However, willingness declined significantly with cost. Policy frameworks are needed in Japan to improve access to CGP-guided off-label therapies.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing radiation therapy for merkel cell carcinoma: evaluating prognostic factors and treatment outcomes.","authors":"Minori Niwa, Masanari Niwa, Natsuo Tomita, Hiromichi Ishiyama, Ayaka Uchida, Yukihiko Oshima, Hirota Takano, Masayuki Matsuo, Mayu Kuno, Akifumi Miyakawa, Shinya Otsuka, Toru Matsui, Shintaro Yamamoto, Taiki Takaoka, Dai Okazaki, Akira Torii, Nozomi Kita, Seiya Takano, Motoki Nakamura, Hiroshi Kato, Akimichi Morita, Akio Hiwatashi","doi":"10.1007/s10147-025-02838-7","DOIUrl":"https://doi.org/10.1007/s10147-025-02838-7","url":null,"abstract":"<p><strong>Background: </strong>Merkel cell carcinoma (MCC) is a highly aggressive neuroendocrine skin cancer. Surgery and radiation therapy (RT) are common treatment options; however, an optimal RT strategy has yet to be established. Therefore, the present study examined the outcomes of MCC patients treated with RT, with the aim of elucidating current RT practices and identifying prognostic factors for RT optimization.</p><p><strong>Methods: </strong>This was a retrospective analysis of 32 non-metastatic MCC patients treated with RT. Local control (LC), progression-free survival (PFS), and overall survival (OS) rates were calculated using the Kaplan-Meier method. The Log-rank test was used to examine the effect of each factor on outcomes.</p><p><strong>Results: </strong>Median age was 80 years, with a median follow-up period of 26 months. The median dose was 52 Gy in 26 fractions and combined with surgery in 23 patients. Two-year LC, PFS, and OS rates were 94, 61, and 74%, respectively. The Log-rank test showed that tumor size ≥ 5 cm was associated with worse LC (p = 0.03). Male sex and the absence of surgery correlated with worse PFS (p = 0.047 and 0.023, respectively). Performance status ≥ 2, the absence of surgery, and RT margin < 3 cm correlated with worse OS (p = 0.006, 0.02, and 0.02, respectively). RT dose, intensity-modulated RT, and elective nodal irradiation were not associated with any outcomes in this population.</p><p><strong>Conclusion: </strong>RT achieved high local control; however, the metastasis rates were high. A wide RT margin and the combination of RT with surgery may improve the outcomes of MCC patients.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Onco-nephrology in clinical practice: pharmacokinetics, monitoring, and treatment strategies for patients with cancer and impaired renal function.","authors":"Shunsaku Nakagawa, Keiko Ikuta, Takashi Masuda, Tomohiro Terada","doi":"10.1007/s10147-025-02832-z","DOIUrl":"https://doi.org/10.1007/s10147-025-02832-z","url":null,"abstract":"<p><p>Renal dysfunction is common in patients with cancer and affects their pharmacokinetics, thereby altering treatment efficacy and safety. This review outlines the principles of dose adjustment based on renal function and highlights specific issues in patients undergoing dialysis or with proteinuria. In patients undergoing dialysis, dose adjustment can be rational if drug properties such as molecular weight and protein binding are considered. Metabolites of some drugs, such as fluorouracil (5-FU), may accumulate in patients with impaired renal function, thereby increasing the risk of toxicity. For oxaliplatin, increased platinum exposure in patients undergoing dialysis does not necessarily increase toxicity, possibly because reactive platinum species are eliminated independent of renal function. Proteinuria can lead to reduced drug exposure to monoclonal antibodies owing to abnormal urinary excretion. The early detection and management of drug-induced kidney injuries are essential. These strategies include identifying risk factors, adjusting doses, and implementing monitoring systems. Protocol-based approaches, such as pharmacist-led monitoring, can improve cancer pharmacotherapy. Automated systems and AI-based models have also been explored for risk prediction. Future studies should focus on deepening our understanding of pharmacokinetics in patients with advanced chronic kidney disease (CKD) or those on dialysis. Multidisciplinary collaboration in onco-nephrology is important to improve cancer care in this growing population.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical advantages of two vs. three courses of neoadjuvant chemotherapy using docetaxel + cisplatin + 5-fluorouracil to improve preoperative nutritional status and mitigate decreasing skeletal muscle in resectable esophageal cancer.","authors":"Kazuaki Matsui, Yutaka Miyawaki, Ryota Kobayashi, Masatoshi Yoshizawa, Tetsuro Toriumi, Gen Ebara, Hiroshi Sato, Shinichi Sakuramoto","doi":"10.1007/s10147-025-02839-6","DOIUrl":"https://doi.org/10.1007/s10147-025-02839-6","url":null,"abstract":"<p><strong>Purpose: </strong>Neoadjuvant chemotherapy (NAC) using docetaxel/cisplatin/5-fluorouracil (DCF) for locally advanced esophageal cancer (EC) showed better clinical outcomes than conventional regimens; however, had high incidence of serious adverse events.</p><p><strong>Methods: </strong>Patients who underwent radical esophagectomy after neoadjuvant-DCF were classified into two-course and three-course groups (n = 60 and 41). Multiple clinical indicators related to nutrition and skeletal muscle that were reported to be associated with survival outcomes were compared between the two groups.</p><p><strong>Results: </strong>Changes in prognostic nutritional index (PNI), geriatric nutritional risk index (GNRI), and psoas muscle area (PMA) were significantly low in the three-course group (p < 0.001, < 0.001, and = 0.003). Multivariate analyses for PNI change rate showed initial PNI < 45 and three-course DCF as independent associated factors (B = 0.129; p < 0.001 and B =  - 0.057; p = 0.022); GNRI change rate showed body mass index ≥ 21, initial PNI < 45, and three-course DCF as independent associated factors (B =  - 0.033; p < 0.001, B = 0.062; p < 0.001, and B =  - 0.059; p < 0.001); PMA change rate showed three-course DCF and cStage IV as independent associated factors (B =  - 0.024; p = 0.011 and B =  - 0.025; p = 0.038). There were not significant differences in the long-term survivals between the two groups in pStages I-IV.</p><p><strong>Conclusions: </strong>Two courses were superior to three courses for improving nutritional status and mitigating skeletal muscle decreasing during NAC-DCF for EC.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144659151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk stratification for recurrence after nephrectomy in high-risk renal cell carcinoma patients.","authors":"Taisuke Tobe, Jun Teishima, Hideto Ueki, Yusuke Shiraishi, Naoto Wakita, Yasuyoshi Okamura, Kotaro Suzuki, Yukari Bando, Takuto Hara, Tomoaki Terakawa, Koji Chiba, Akihisa Yao, Hideaki Miyake","doi":"10.1007/s10147-025-02825-y","DOIUrl":"https://doi.org/10.1007/s10147-025-02825-y","url":null,"abstract":"<p><strong>Background: </strong>To identify prognostic factors that guide adjuvant therapy decisions, we investigated factors predicting recurrence in patients with high-risk clear cell renal cell carcinoma (RCC) after nephrectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with non-metastatic, high-risk clear cell RCC who underwent radical or partial nephrectomy at our institution and affiliated centers between January 2016 and March 2024. Multivariate analysis using the Cox proportional hazards model was performed to identify clinicopathological factors associated with recurrence. On the basis of these factors, we developed a risk stratification model.</p><p><strong>Results: </strong>A total of 338 patients were included. The 5-year recurrence-free survival (RFS) rate was 54.3%. Multivariate analysis identified a body mass index of ≤ 22 kg/m² (Hazard Ratio [HR]: 2.61), rhabdoid differentiation (HR: 5.14), anemia (HR: 1.97), hypercalcemia (HR: 2.67), and C-reactive protein ≥ 0.5 mg/dL (HR: 1.72) as independent predictors of recurrence. RFS was significantly different between patients with varying numbers of risk factors: 3-year RFS rates were 22.6% for those with 3-4 factors, 47.9% for those with two, 75.5% for those with one, and 83.6% for those with none.</p><p><strong>Conclusion: </strong>We identified independent predictors of recurrence in patients with nephrectomy-treated clear cell RCC. Patients stratified according to a risk score based on these factors had different recurrence rates, suggesting that this score could assist in guiding adjuvant therapy decisions.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trends in real-world outcomes of patients with metastatic renal cell cancer in the recent treatment era: a single-institution analysis.","authors":"Yasutomo Nakai, Shunki Nakagawa, Yutaka Kurahashi, Shu Okamoto, Yuichiro Nakamura, Yujiro Hayashi, Norihiko Kawamura, Akira Nagahara, Kazuo Nishimura, Masashi Nakayama","doi":"10.1007/s10147-025-02829-8","DOIUrl":"https://doi.org/10.1007/s10147-025-02829-8","url":null,"abstract":"<p><strong>Background: </strong>Systemic therapy for metastatic renal cell cancer (mRCC) has changed significantly due to randomized controlled trial results. We investigated whether these changes affect real-world outcomes and clarified factors associated with treatment outcomes in patients from a single institution outside of clinical trials.</p><p><strong>Methods: </strong>We retrospectively reviewed records of mRCC patients treated at Osaka International Cancer Institute between January 2005 and May 2024. Between-group analysis of progression-free survival (PFS) and overall survival (OS) by Kaplan-Meier comparison and identification of survival-associated factors by univariate and multivariate analyses were performed. Patients assumed ineligible for clinical trials were analyzed in subgroups according to any of Eastern Cooperative Oncology Group performance status > 1, hemoglobin level < 9.0 g/dL, estimated glomerular filtration rate < 40 mL/min/1.73 m², platelet count < 100,000/μL, neutrophil count < 1500/μL, non-clear cell histology, or brain metastasis.</p><p><strong>Results: </strong>In total, 320 patients were evaluated: 2005-2009, n = 58; 2010-2014, n = 77; 2015‒2019, n = 86; and 2020‒2024, n = 99. Significant between-group differences were observed for median PFS (7 vs. 8 vs. 12 vs. 20 months; p = 0.0048) and (35 vs. 38 vs. 67 vs. 52 months; p = 0.0206). Multivariate analysis revealed that first-line or subsequent-line immune checkpoint inhibitor (ICI) use was an independent factor for OS (HR: 0.28, p < 0.0001). Even among 112 (35%) trial-ineligible patients, multivariate analysis demonstrated that the use of first-line or subsequent-line ICI was an independent factor for OS (HR: 0.26, p < 0.0001).</p><p><strong>Conclusion: </strong>Over time, treatment outcomes appeared to have improved with real-world treatment for mRCC, with use of ICIs being related to improvements in treatment outcomes.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144626252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}