International Journal of Clinical Oncology

, Volume 24, Issue 10, pp 1231–1237 | Cite as

Prognostic factors and survival in Japanese patients with brain metastasis from renal cell cancer

  • Nobushige TakeshitaEmail author
  • Masafumi Otsuka
  • Tomohiko Kamasako
  • Takatoshi Somoto
  • Toshihiro Uemura
  • Tetsuo Shinozaki
  • Masayuki Kobayashi
  • Hidetada Kawana
  • Makiko Itami
  • Toshihiko Iuchi
  • Atsushi Komaru
  • Satoshi Fukasawa
Original Article



Patients with brain metastasis from renal cell carcinoma have poor outcomes despite recent advances in diagnosis and treatment. Moreover, factors affecting such poor outcomes are unclear. This study aimed to evaluate the prognostic factors associated with overall survival in renal cell carcinoma patients with brain metastasis.


We retrospectively reviewed the data of 50 consecutive patients with brain metastasis from renal cell carcinoma at our institution between 1988 and 2017. The evaluated prognostic factors for overall survival included clinicopathological factors at diagnosis, treatment for brain metastasis, and the Graded Prognostic Assessment score of renal cell carcinoma. The associations between preoperative clinicopathological factors and overall survival were assessed using the log-rank test and Cox proportional hazards models for univariate and multivariate analyses, respectively.


Forty-five patients were included, among whom 39 died during follow-up. The median follow-up was 8.2 months. The median survival time was 8.2 months (95% confidence interval 5.5–13.7). A Graded Prognostic Assessment score ≤ 2 (hazard ratio 1.967; 95% confidence interval 1.024–3.892; P = 0.042), the presence of sarcomatoid components (hazard ratio 3.299; 95% confidence interval 1.424–7.193; P = 0.007), and no treatment for brain metastasis (hazard ratio 2.594; 95% confidence interval 1.033–5.858; P = 0.043) were independently associated with poor prognosis in the multivariate analysis.


Patients with renal cell carcinoma who develop brain metastasis have poor overall survival. The Graded Prognostic Assessment score, sarcomatoid components, and treatment for brain metastasis from renal cell carcinoma were independent factors associated with prognosis.


Brain metastasis Graded Prognostic Assessment Score Prognosis Renal cell carcinoma Sarcomatoid component 



The authors thank Editage for English language editing.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.


  1. 1.
    Siegel RL, Miller KD, Jemal A (2018) Cancer statistics, 2018. CA Cancer J Clin 68:7–30CrossRefGoogle Scholar
  2. 2.
  3. 3.
    Heng DYC, Xie W, Regan MM et al (2013) External validation and comparison with other models of the International Metastatic Renal-Cell Carcinoma Database Consortium prognostic model: a population-based study. Lancet Oncol 14:141–148CrossRefGoogle Scholar
  4. 4.
    Shuch B, La Rochelle JC, Klatte T et al (2008) Brain metastasis from renal cell carcinoma: presentation, recurrence, and survival. Cancer 113:1641–1648CrossRefGoogle Scholar
  5. 5.
    Bates JE, Youn P, Peterson CR et al (2017) Radiotherapy for brain metastases from renal cell carcinoma in the targeted therapy era: the University of Rochester experience. Am J Clin Oncol 40:439–443CrossRefGoogle Scholar
  6. 6.
    Verma J, Jonasch E, Allen PK et al (2013) The impact of tyrosine kinase inhibitors on the multimodality treatment of brain metastases from renal cell carcinoma. Am J Clin Oncol 36:620–624CrossRefGoogle Scholar
  7. 7.
    Fokas E, Henzel M, Hamm K et al (2010) Radiotherapy for brain metastases from renal cell cancer: should whole-brain radiotherapy be added to stereotactic radiosurgery? Analysis of 88 patients. Strahlenther Onkol 186:210–217CrossRefGoogle Scholar
  8. 8.
    Ikushima H, Tokuuye K, Sumi M et al (2000) Fractionated stereotactic radiotherapy of brain metastases from renal cell carcinoma. Int J Radiat Oncol Biol Phys 48:1389–1393CrossRefGoogle Scholar
  9. 9.
    Dabestani S, Marconi L, Hofmann F et al (2014) Local treatments for metastases of renal cell carcinoma: a systematic review. Lancet Oncol 15:e549–e561CrossRefGoogle Scholar
  10. 10.
    Sperduto PW, Kased N, Roberge D et al (2012) Summary report on the graded prognostic assessment: an accurate and facile diagnosis-specific tool to estimate survival for patients with brain metastases. J Clin Oncol 30:419–425CrossRefGoogle Scholar
  11. 11.
    Decker DA, Decker VL, Herskovic A et al (1984) Brain metastases in patients with renal cell carcinoma: prognosis and treatment. J Clin Oncol 2:169–173CrossRefGoogle Scholar
  12. 12.
    Amendola BE, Wolf AL, Coy SR et al (2000) Brain metastases in renal cell carcinoma: management with gamma knife radiosurgery. Cancer J 6:372–376Google Scholar
  13. 13.
    Sperduto PW, Chao ST, Sneed PK et al (2010) Diagnosis-specific prognostic factors, indexes, and treatment outcomes for patients with newly diagnosed brain metastases: a multi-institutional analysis of 4259 patients. Int J Radiat Oncol Biol Phys 77:655–661CrossRefGoogle Scholar
  14. 14.
    Ali MA, Hirshman BR, Wilson B et al (2017) Improving the prognostic value of disease-specific graded prognostic assessment model for renal cell carcinoma by incorporation of cumulative intracranial tumor volume. World Neurosurg 108:151–156CrossRefGoogle Scholar
  15. 15.
    Du Y, Pahernik S, Hadaschik B et al (2016) Impact of resection and systemic therapy on the survival of patients with brain metastasis of metastatic renal cell carcinoma. J Neurooncol 130:221–228CrossRefGoogle Scholar
  16. 16.
    Bastos DA, Molina AM, Hatzoglou V et al (2015) Safety and efficacy of targeted therapy for renal cell carcinoma with brain metastasis. Clin Genitourin Cancer 13:59–66CrossRefGoogle Scholar
  17. 17.
    Kwak C, Park YH, Jeong CW et al (2007) Sarcomatoid differentiation as a prognostic factor for immunotherapy in metastatic renal cell carcinoma. J Surg Oncol 95:317–323CrossRefGoogle Scholar
  18. 18.
    Mian BM, Bhadkamkar N, Slaton JW et al (2002) Prognostic factors and survival of patients with sarcomatoid renal cell carcinoma. J Urol 167:65–70CrossRefGoogle Scholar
  19. 19.
    Choi SY, Yoo S, You D et al (2017) Prognostic factors for survival of patients with synchronous or metachronous brain metastasis of renal cell carcinoma. Clin Genitourin Cancer 15:717–723CrossRefGoogle Scholar
  20. 20.
    Maria B, Antonella V, Michela R et al (2016) Multimodality treatment of brain metastases from renal cell carcinoma in the era of targeted therapy. Ther Adv Med Oncol 8:450–459CrossRefGoogle Scholar
  21. 21.
    Motzer RJ, Jonasch E, Agarwal N et al (2017) Kidney cancer, version 2.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw 15:804–834CrossRefGoogle Scholar
  22. 22.
    Gore ME, Hariharan S, Porta C et al (2011) Sunitinib in metastatic renal cell carcinoma patients with brain metastases. Cancer 117:501–509CrossRefGoogle Scholar
  23. 23.
    Nieder C, Spanne O, Nordoy T et al (2011) Treatment of brain metastases from renal cell cancer. Urol Oncol 29:405–410CrossRefGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Prostate Center and Division of UrologyChiba Cancer CenterChibaJapan
  2. 2.Division of Surgical PathologyChiba Cancer CenterChibaJapan
  3. 3.Division of Neurological SurgeryChiba Cancer CenterChibaJapan

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