Sarcomatoid renal cell carcinoma: clinical outcome and survival after treatment with sunitinib

Victoria Kunene, Manuela Miscoria, Sarah Pirrie, Mohammad R. Islam, Mehran Afshar, Emilio Porfiri*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Background: Renal tumors with sarcomatoid changes are aggressive malignancies with poor prognosis. Immunotherapy and chemotherapy have provided little benefit. The efficacy of treatments targeting the vascular endothelial growth factor pathway is unclear because of the lack of clinical trial data and the small number of published series. Patients and Methods: We reviewed the clinical records of 23 consecutive patients with advanced sarcomatoid renal cell carcinoma who were treated with sunitinib in our center. Overall survival (OS), progression-free survival, and response rate were evaluated. We also studied the effect on clinical outcome of performance status, prognostic risk group, and proportion of sarcomatoid component. Results:  Median OS was 15.7 months (95% confidence interval [CI], 5.0-21.2). Median progression-free survival was 5.7 months (95% CI, 3.2-12.6). Seven patients (30%) had an objective response, 5 patients (22%) had stable disease, and 11 (48%) had progressive disease. The median survival of the 13 (56.5%) patients with performance status of 0 to 1 was 20.9 months (95% CI, 9.7-63.3) whereas the medial survival of the 10 (43.5%) patients with performance status of 2 to 3 was 5.0 months (95% CI, 1.1-16.5). Objective responses were observed only among the 13 (56.5%) patients with performance status of 0 to 1. Heng prognostic risk group and percentage of sarcomatoid component did not influence outcome. Conclusion: Sunitinib shows efficacy in advanced renal tumors with sarcomatoid differentiation particularly in patients with good performance status. Appropriate patient selection and risk-directed treatment remains essential in this aggressive disease.

Original languageEnglish
Pages (from-to)251-255
Number of pages5
JournalClinical Genitourinary Cancer
Issue number4
Early online date27 Dec 2013
Publication statusPublished - 1 Aug 2014


  • Performance status
  • Renal cell carcinoma
  • Risk-directed treatment
  • Sarcomatoid differentiation
  • Sunitinib

ASJC Scopus subject areas

  • Oncology
  • Urology


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