Real-world study on characteristics, post-nephrectomy journey, and outcomes of patients with early-stage renal cell carcinoma based on risk groups

This study evaluated the patient (pt) characteristics, post-nephrectomy journey, and outcomes for non-metastatic renal cell carcinoma (RCC) pts with varying risk of recurrence.

This retrospective analysis identified pts, age ≥18 years, with non-metastatic RCC with nephrectomy between January 2012-December 2017. Pts were identified from the ConcertAI Oncology Dataset which draws electronic medical records from diverse community oncology clinics in the US. Pts were stratified into intermediate (int)-high (pT2N0G4, pT3N0Any Grade) or high risk (pT4N0Any Grade, pTanyN1Any Grade) RCC. Time-to-event outcomes including recurrence and overall survival (OS) were examined using Kaplan-Meier methods.

439 pts were identified (int-high: 85.9%, high risk: 14.1%). Median age was 64.0 years, 66.1% were male, 80.0% were White, and 76.5% had clear cell histology. Median follow-up was 41 months for int-high and 24 months for high risk. Of pts with documentation of postoperative imaging (n=260), the median time from initial nephrectomy to first follow-up imaging was 110 days for int-high and 51 days for high risk. 72% of imaging assessments were ordered by oncologists. 68.4% of int-high and 56.5% of high risk pts had ≥1 oncologist visit post nephrectomy. Median time to first in-network oncologist visit post nephrectomy was 265 days, and 41.7% of pts who recurred (n=223) had ≥1 in-network oncologist visits before recurrence. High grade int-high risk disease (T2G4, T3G4) showed similar prognosis as those with high risk disease. 29.1% of T3G2 and 47.5% of T3G3 pts had recurrence by 3 years.

This study shows post-nephrectomy treatment patterns in the pre-immuno-oncology era in a real-world setting. The study observed substantial 3-yr recurrence rates within the int-high risk and high risk groups. These results are indicative of a high unmet need for effective post-nephrectomy treatment options in a pt population similar to that included in the adjuvant RCC trials.