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Kidney cancer: personalized treatment increases patient survival


A study of nearly 1,500 patients treated for kidney cancer at UCLA ( University of California Los Angeles ) in the last 15 years has shown that an aggressive, tailored treatment approach results in better survival rates and uncovered subsets of kidney cancer that behave differently and need to be treated accordingly.

The one-size-fits-all approach traditionally used in kidney cancer treatment should be changed based on the results of the study, the longest to date to analyze kidney cancer patients and their outcomes.

The study is published in of Cancer, the journal of the American Cancer Society.

The study found that patients with localized kidney cancer could have either low, intermediate or high risk cancers based on the chance for recurrence. Patients with cancers that have already spread also fell into similarly different subsets. Some have better outcomes while others may have very aggressive cancers that may not warrant treatment.

If a patient with localized cancer is identified as low risk, his five-year survival rate is expected to be 97 percent, while his 10-year survival rate is 92 percent. An intermediate risk patient with localized disease would have a five-year survival rate of 81 percent and a 10-year survival rate of 61 percent. A high risk patient has a five-year survival rate of 62 percent, with a 10-year survival of 41 percent.

The study showed that a patient with low-risk, localized kidney cancer could be treated only with surgery and expect an excellent outcome. Such a move would spare the patient from having to undergo radiation or immunotherapy, which result in harsh side effects. However, for a patient with high-risk, localized kidney cancer, surgery would not be enough. Additional therapy such as targeted treatments or immunotherapy should be considered in order to give the patient the best possible outcome.

In metastatic patients, someone with low-risk cancer should get very aggressive treatment, because there's a good chance the therapy will help the patient. Those with high-risk, metastatic disease won't get much, if any, benefit from treatment and may want to forego surgery and the toxic therapies.

The study represents 15 years of experience in UCLA's leading-edge kidney cancer program. The study analyzed the first 1,492 patients treated in the program.

About 25 percent of the patients with metastatic kidney cancer achieved long-term responses, five to 15 year survivals, from their therapy. Less than 5 percent of metastatic kidney cancer patient typically achieve long term survivals or a cure when treated with conventional treatments.

Source: University of California Los Angeles, 2008

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