Original Study| Volume 20, ISSUE 6, P533-542, December 2022

Download started.


Management and Health Resource Use of Patients With Metastatic Renal Cell Carcinoma treated With Systemic Therapy Over 2014-2017 in France: A National Real-World Study



      The introduction of novel systemic therapies for metastatic renal cell carcinoma (mRCC) over the last decade has significantly improved patient outcomes. Little information is available on treatment modalities and outcomes in everyday practice. The objective of this study was to describe patient characteristics, treatment patterns, and healthcare resource use in mRCC patients receiving systemic therapy in France (2014-2017), using the nationwide claims database.

      Patients and Methods

      Patients with a diagnosis of RCC (ICD-10: C64) between 2009 and 2017 and receiving a first systemic treatment for mRCC between 2014 and 2017 were eligible. Patients were divided into two groups at diagnosis, Group A: metastatic RCC and Group B: localized RCC.


      4,929 eligible patients were identified (Group A: 2638 patients, 53.5%; Group B: 2,291 patients,46.5%). Median age was 66 years and 73% were men. In patients with incident RCC (N = 3,425), 62.3% underwent nephrectomy (94.4% in Group B). Within the year following mRCC diagnosis, 86.5% were hospitalized at least once; among them 58.1% for RCC. Nearly 31% of patients underwent radiotherapy. First line treatment was sunitinib for 65% of patients and pazopanib for 24%. Twenty five percent and 10% of patients received 2 and 3 lines of systemic treatment, respectively. The 2-year survival rate after mRCC diagnosis was 44%, with median overall survival of 20 [95%CI: 19-21] months (14 and 28 in Group A and B).


      This study documented patient characteristics, treatment patterns and survival outcomes in mRCC patients receiving systemic therapy in France (2014-2017). Estimated survival rates were consistent with real-world studies from other countries.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Clinical Genitourinary Cancer
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Ferlay J
        • Colombet M
        • Soerjomataram I
        • et al.
        Cancer incidence and mortality patterns in Europe: estimates for 40 countries and 25 major cancers in 2018.
        Eur J Cancer. 2018; 103: 356-387
        • Defossez G
        • Le Guyader Peyrou S
        • Uhry Z
        • et al.
        Estimations nationales de l'incidence et de la mortalité par cancer en France métropolitaine entre 1990 et 2018. . Vol Volume 1 - Tumeurs solides.
        Étude à partir des registres des cancers du réseau Francim. Sante publique France, Saint‑Maurice2019
        • Ljungberg B
        • Campbell SC
        • Choi HY
        • et al.
        The epidemiology of renal cell carcinoma.
        Eur Urol. 2011; 60: 615-621
        • Hsieh JJ
        • Purdue MP
        • Signoretti S
        • et al.
        Renal cell carcinoma.
        Nat Rev Dis Primers. 2017; 3: 17009
        • Gray RE
        • Harris GT.
        Renal cell carcinoma: diagnosis and management.
        Am Fam Physician. 2019; 99: 179-184
        • Escudier B
        • Porta C
        • Schmidinger M
        • et al.
        Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up.
        Ann Oncol. 2016; 27: v58-v68
        • Lin J
        • Kamamia C
        • Shriver CD
        • Zhu K.
        Race and renal cell carcinoma stage at diagnosis: an analysis of the surveillance, epidemiology, and end results data.
        Eur J Cancer Prev. 2019; 28: 350-354
        • Siegel RL
        • Miller KD
        • Jemal A.
        Cancer statistics, 2018.
        CA Cancer J Clin. 2018; 68: 7-30
        • Escudier B
        • Porta C
        • Schmidinger M
        • et al.
        Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-updagger.
        Ann Oncol. 2019; 30: 706-720
        • Sanchez-Gastaldo A
        • Kempf E
        • Gonzalez Del Alba A
        • Duran I
        Systemic treatment of renal cell cancer: a comprehensive review.
        Cancer Treat Rev. 2017; 60: 77-89
        • Maroun R
        • Fleury L
        • Nachbaur G
        • et al.
        Real-world costs and outcomes in metastatic renal cell carcinoma patients treated with targeted therapies: a cohort study from the French health insurance database.
        Curr Med Res Opin. 2017; 33: 1755-1762
        • Tuppin P
        • Paita M
        • Gastaldi-Menager C
        • et al.
        Patient characteristics and treatments one year after diagnosis of renal cancer in 2015 according to the presence or absence of metastasis and a history of another tumour: a national observational study.
        Bull Cancer. 2019; 106: 538-549
        • Scailteux LM
        • Droitcourt C
        • Balusson F
        • et al.
        French administrative health care database (SNDS): the value of its enrichment.
        Therapie. 2019; 74: 215-223
        • Quantin C.
        Etude des algorithmes de définition de pathologies dans le système national d'information inter-régimes de l'assurance maladie (SNIIRAM).
        Caisse nationale d'Assurance maladie des travailleurs salariés, Paris2015
        • Ljungberg B
        • Albiges L
        • Abu-Ghanem Y
        • et al.
        European association of urology guidelines on renal cell carcinoma: the 2019 update.
        Eur Urol. 2019; 75: 799-810
        • Motzer RJ
        • Jonasch E
        • Agarwal N
        • et al.
        Kidney Cancer, version 2.2017, NCCN clinical practice guidelines in oncology.
        J Natl Compr Canc Netw. 2017; 15: 804-834
        • Bensalah K
        • Albiges L
        • Bernhard JC
        • et al.
        [French ccAFU guidelines - update 2018-2020: management of kidney cancer].
        Prog Urol. 2018; 28: R5-R33
        • Fuentes S
        • Mandereau-Bruno L
        • Regnault N
        • et al.
        Is the type 2 diabetes epidemic plateauing in France? a nationwide population-based study.
        Diabetes Metab. 2020; 46: 472-479
        • Mandereau-Bruno L
        • Denis P
        • Fagot-Campagna AF
        • Fosse-Edorh S.
        Prévalence du diabète traité pharmacologiquement et disparités territoriales en France en 2012.
        Bull Epidémiol Hebd. 2014; 30-31: 493-499
        • Perrine AL
        • Lecoffre C
        • Blacher J
        • Olié V.
        L'hypertension artérielle en France: prévalence, traitement et contrôle en 2015 et évolutions depuis 2006.
        Bull Epiemiol Hebd. 2018; 10: 170-179
        • Lassalle M
        • Monnet E
        • Ayav C
        • et al.
        2017 Annual report digest of the renal epidemiology information network (REIN) registry.
        Transpl Int. 2019; 32: 892-902
        • Escudier B
        • Porta C
        • Schmidinger M
        • et al.
        Renal cell carcinoma: ESMO clinical practice guidelines for diagnosis, treatment and follow-up.
        Ann Oncol. 2014; 25: iii49-iii56
        • Maroun R
        • Maunoury F
        • Benjamin L
        • et al.
        In-hospital economic burden of metastatic renal cell carcinoma in france in the era of targeted therapies: analysis of the french national hospital database from 2008 to 2013.
        PLoS One. 2016; 11e0162864
        • Rappold PM
        • Silagy AW
        • Kotecha RR
        • Hakimi AA.
        Immune checkpoint blockade in renal cell carcinoma.
        J Surg Oncol. 2021; 123: 739-750
        • Thiery-Vuillemin A
        • Cholley T
        • Calcagno F
        • et al.
        Factors influencing overall survival for patients with metastatic clear-cell renal-cell carcinoma in daily practice.
        Clinical genitourinary cancer. 2018; 16: e297-e305
        • Sternberg CN
        • Hawkins RE
        • Wagstaff J
        • et al.
        A randomised, double-blind phase III study of pazopanib in patients with advanced and/or metastatic renal cell carcinoma: final overall survival results and safety update.
        Eur J Cancer. 2013; 49: 1287-1296
        • Motzer RJ
        • Hutson TE
        • Tomczak P
        • et al.
        Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma.
        J Clin Oncol. 2009; 27: 3584-3590
        • Hawkins R
        • Fife K
        • Hurst M
        • et al.
        Treatment patterns and health outcomes in metastatic renal cell carcinoma patients treated with targeted systemic therapies in the UK.
        BMC Cancer. 2020; 20: 670