Management and outcomes of patients with renal medullary carcinoma (RMC): A multicenter retrospective study of 39 patients.
Bibliographic record
Abstract
438 Background: RMC is a rare and aggressive neoplasm that afflicts primarily young black patients with sickle cell trait. Our primary objective is to report the outcomes of RMC patients through a collaborative initiative. Methods: After IRB approval, we retrospectively reviewed records of RMC patients treated from 2000-2013 at 7 academic institutions. Overall survival (OS) was calculated from RMC diagnosis to date of death. Descriptive statistics were used. Results: A total of 39 patients were included. Median age was 27.8 years and 29 (74%) were males. 38 (97%) had sickle cell trait. Median renal tumor size at presentation was 5.8 cm (range 3.4-11.4 cm). 3 patients presented with stage I disease, 13 with stage III disease, and 23 with stage IV disease. 22 patients had ECOG PS 0-1 and 17 had ECOG PS 2-3. The most common metastatic sites at diagnosis were lymph nodes in 27 and lung in 13. 26 patients (66.7%) had a nephrectomy. Pathologic stage was pT1-2 in 6 and pT3-4 in 20. 23 of these patients (88.5%) had positive lymph nodes at RPLND. 7 patients received preoperative systemic therapy. Median duration of pre-op therapy was 16 weeks (range 12-27 weeks). 1 patient had CR, 3 had PR and 3 had SD as best response to pre-op therapy. All patients received at least 1 line of systemic therapy. Median OS was 12.2 months. One patient had clinical CR with preoperative chemotherapy, near path CR on nephrectomy, and is currently NED at 27.4 mos. 5 patients are alive to date, though no patients have survived past 37 months. Conclusions: Patients withRMC have a grave prognosis. Nephrectomy (upfront or delayed) was associated with improved OS, even in patients with poor PS, though poor PS patients should be considered for upfront chemo. More effective therapies are desperately needed to improve patient outcomes. [Table: see text]
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".