Real-world characteristics, treatment patterns, and outcomes of renal cell carcinoma at a high-complexity center in southwestern Colombia.

Abstract

e16548 Background: Real-world data on renal cell carcinoma (RCC) in Latin America are limited, despite the widespread adoption of tyrosine kinase inhibitors (TKIs) and immune checkpoint inhibitors (ICIs) in metastatic disease. Differences in access to treatment, patient characteristics, and clinical practice may influence outcomes compared with clinical trial populations. This study aimed to describe clinical characteristics, treatment patterns, and outcomes of patients with RCC at a Colombian referral center. Methods: We conducted a retrospective cohort study including patients with histologically confirmed RCC diagnosed between 2014 and 2024 at Fundación Valle del Lili, Cali, Colombia. Demographic, clinicopathologic, and treatment-related variables were collected. Outcomes included overall survival (OS), progression-free survival (PFS), and disease-free survival (DFS). Survival outcomes were estimated using the Kaplan-Meier method, and univariable Cox proportional hazards models were used to evaluate factor associated with OS. Results: A total of 1,064 patients met inclusion criteria. Median age was 60 years (IQR: 52-69) and 59.4% were male. Clear cell RCC was the most frequent histological subtype (72.8%, n = 775). At diagnosis, 86.3% (n = 918) had localized disease, of whom 13.3% (n = 122) developed recurrent disease during follow-up, while 13.7% (n = 146) presented with de novo metastatic disease. Among these 268 patients with advanced disease, 227 (84.7%) received systemic therapy. First-line regimens consisted of TKI monotherapy (52.8%), ICIs plus TKI (27.7%), and dual ICIs (17.1%). Among patients progressing on first-line therapy, 124 (54.6%) received second-line treatment, predominantly TKI monotherapy (45.2%) and ICI monotherapy (21.8%). Median OS was 31.1 months (95% CI 18.2-40.9) in patients with de novo metastatic disease. Among patients with metastatic or recurrent disease who received systemic therapy, median PFS was 41.9 months (95% CI 32.4-55.8). Median DFS in patients with localized disease was 156.7 months (95% CI 137.0-176.7). In univariable analysis, age ≥65 years (HR 2.29, 95% CI 1.66–3.17, p < 0.0001) and ECOG performance status 2–4 (HR 3.20, 95% CI 1.89–5.42; p < 0.0001) were associated with worse OS. Conclusions: This large real-world cohort provides a comprehensive characterization of patients with renal cell carcinoma treated at a high-complexity referral center in southwestern Colombia. The observed heterogeneity in clinical presentation, treatment patterns, and survival outcomes highlights the challenges of RCC management in routine practice and underscores the value of locally generated real-world evidence to inform clinical decision-making in Latin American populations.