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Background <p>There are few large population-based studies characterizing brain metastases (BM) in patients with renal cell carcinoma (RCC). The aim of this study was to investigate BM prevalence and their impact on treatment patterns and overall survival (OS) in RCC patients diagnosed between 2014 and 2024.</p> Methods <p>Data from patients with histologically confirmed RCC were extracted from the TriNetX Oncology database. Clinical and demographic variables were compared between patients with and without BM using Chi-squared and t-tests. Cox regression analyses were used to evaluate OS, after propensity score matching cohorts for age at diagnosis, sex, stage at diagnosis, cancer-directed therapy, and extracranial metastases.</p> Results <p>A total of 14,650 patients with RCC were identified, including 730 (5.0%) who developed BM. Patients with BM had higher rates of extracranial metastases and were more likely to receive radiation and antineoplastic medications than patients without BM. Patients with BM had significantly lower OS compared to those with extracranial metastases only (HR[95%CI] = 1.38[1.19–1.59]), with median survival times of 4.0 years from the diagnosis of RCC and 1.2 years from the BM diagnosis. From the time of diagnosis of RCC, patients with synchronous BM (diagnosed ≤ 2 months of RCC diagnosis) had poorer OS compared to patients with metachronous (diagnosed &gt; 2 months of RCC diagnosis) BM (HR[95%CI] = 1.95[1.46–2.60]), but there was no significant difference in OS following the BM diagnosis between these groups (HR[95%CI] = 0.92[0.67–1.27]).</p> Conclusions <p>Here we demonstrated the increased morbidity, mortality, and complexity in management associated with BM in patients with RCC, regardless of their chronicity.</p>

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Brain metastases from renal cell carcinoma: a large retrospective claims-based oncology cohort analysis of prevalence, chronicity, and survival outcomes

  • 期刊论文

  • 发表日期：

    2025年12月12日

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  • Megan Parker,
  • Austin Carmichael,
  • Alyssa G. Arbuiso,
  • Kelly Jiang,
  • Joshua Materi,
  • Debraj Mukherjee,
  • David O. Kamson,
  • Kristin J. Redmond,
  • Lawrence R. Kleinberg,
  • Yasser Ged,
  • Nirmish Singla,
  • Chetan Bettegowda,
  • Jordina Rincon-Torroella

摘要

Background

There are few large population-based studies characterizing brain metastases (BM) in patients with renal cell carcinoma (RCC). The aim of this study was to investigate BM prevalence and their impact on treatment patterns and overall survival (OS) in RCC patients diagnosed between 2014 and 2024.

Methods

Data from patients with histologically confirmed RCC were extracted from the TriNetX Oncology database. Clinical and demographic variables were compared between patients with and without BM using Chi-squared and t-tests. Cox regression analyses were used to evaluate OS, after propensity score matching cohorts for age at diagnosis, sex, stage at diagnosis, cancer-directed therapy, and extracranial metastases.

Results

A total of 14,650 patients with RCC were identified, including 730 (5.0%) who developed BM. Patients with BM had higher rates of extracranial metastases and were more likely to receive radiation and antineoplastic medications than patients without BM. Patients with BM had significantly lower OS compared to those with extracranial metastases only (HR[95%CI] = 1.38[1.19–1.59]), with median survival times of 4.0 years from the diagnosis of RCC and 1.2 years from the BM diagnosis. From the time of diagnosis of RCC, patients with synchronous BM (diagnosed ≤ 2 months of RCC diagnosis) had poorer OS compared to patients with metachronous (diagnosed > 2 months of RCC diagnosis) BM (HR[95%CI] = 1.95[1.46–2.60]), but there was no significant difference in OS following the BM diagnosis between these groups (HR[95%CI] = 0.92[0.67–1.27]).

Conclusions

Here we demonstrated the increased morbidity, mortality, and complexity in management associated with BM in patients with RCC, regardless of their chronicity.