Objective: To retrospectively analyze the survival of renal cell carcinoma patients with bone metastases, evaluate the effect of treatment and identify the prognostic factors in these patients.
Methods: A total of 66 renal cell carcinoma patients with bone metastases treated at our hospital between October 1990 and October 2010 were divided into 3 groups: solitary bone metastasis referred for radical surgery (n = 19); palliative surgery for solitary/multiple bone metastasis (n = 31); extraosseous metastasis without orthopedic surgery (n = 16). The effects of different variables on survival were determined according to the Kaplan-Meier method and Log-Rank test. And Cox proportional hazard regression model was used to estimate the prognostic factors.
Results: Their mean follow-up period was 25 (6-68) months. The survival significantly improved if bone metastases were solitary (45 vs 29 and 13 months, both P < 0.01), there was no vertebral bone involvement (31 vs 10 months, P < 0.01) and radical surgery was performed (50 vs 28 and 13 months, both P < 0.01). Age, gender, tumor size, alkaline phosphatase and lactate dehydrogenase had no effect on survival (all P > 0.05). Based on Cox regression analysis, survival was influenced by the number of metastasis foci (RR = 0.259, 95%CI:0.075-0.897) , type of procedure (RR = 17.845, 95%CI:4.246-74.992) and vertebral bone involvement (RR = 4.526, 95%CI:1.896-10.803) (all P < 0.05).
Conclusions: Surgery is a better option for achieving local tumor control, providing good function and increasing the survival of patients with bone metastases. And radical resection is indicated for the patients with a solitary metastasis.