ArticleInternational braz j urol : official journal of the Brazilian Society of Urology
Influence of treatment access on survival of metastatic renal cell carcinoma in brazilian cancer center.
Article in International braz j urol : official journal of the Brazilian Society of Urology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 6 citations in OpenAlex.
- Socioeconomic inequities in prostate cancer care: private versus public treatment settings pose a significant impact on overall survival.Einstein (Sao Paulo, Brazil) · 2025Article
- CLINICAL AND EPIDEMIOLOGIC EVALUATION OF DESMOID TUMORS IN A BRAZILIAN SARCOMA REFERENCE CENTER.Acta ortopedica brasileira · 2024Article
- Impact of healthcare inequities on survival in Mexican patients with metastatic renal cell carcinoma.Frontiers in oncology · 2023Article
- Infertility highlighted in International Brazilian Journal of Urology.International braz j urol : official journal of the Brazilian Society of UrologyArticle
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Authors and funding
6 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTyrosine kinase inhibitors (TKI) and immunotherapy improved survival in metastatic renal cell carcinoma (mRCC). Disparities in treatment access are present in healthcare systems globally. The aim of this study was to analyze survival outcomes of mRCC patients treated with first-line TKIs in the public (PHS) and private (PrS) health system in a Brazilian Cancer Center. MATERIALS AND
methodsRecords from all mRCC patients treated with first-line TKIs from 2007-2018 were reviewed retrospectively. Categorial variables were compared by Fisher's exact test. Survival was estimated by Kaplan-Maier method and survival curves were compared using the log-rank test. Prognostic factors were adjusted by Cox regression model.
resultsOf the 171 eligible patients, 37 (21.6%) were PHS patients and 134 (78.4%) were PrS patients. There were no difference in age, gender, or sites of metastasis. PHS patients had worse performance status (ECOG ≥2, 35.1% vs. 13.5%, p=0.007), poorer risk score (IMDC poor risk, 32.4% vs. 16.4%, p=0.09), and less nephrectomies (73% vs. 92.5%, p=0.003) than PrS patients. Median lines of therapy was one for PHS versus two for PrS patients (p=0.03). Median overall survival (OS) was 16.5 versus 26.5 months (p=0.002) and progression-free survival (PFS), 8.4 versus 11 months (p=0.01) for PHS and PrS patients, respectively. After adjusting for known prognostic factors on multivariate analysis, PHS patients still had a higher risk of death (HR: 1.61, 95% CI: 1.01-2.56, p=0.047).
conclusionPatients with mRCC treated via the PHS had worse overall survival, possibly due to poorer prognosis at presentation and less drug access.
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