Metastatic Kidney Cancer Survival Rates: What You Need to Know

A metastatic renal cell carcinoma (RCC) diagnosis can open the door to feelings of fear and uncertainty about your future. After getting the news, you may be eager for information about your options, what to expect in the months ahead, and the survival rates for this type of kidney cancer.

What Do Survival Rates Tell You?

“The best a doctor can do is use clinical trial data to help estimate for a patient their long-term outcome, but there are so many other factors that contribute to this as well,” says Dr. Ornstein.

Factors That Influence Your Prognosis and Survival

Your survival with metastatic RCC can depend on tumor location, response to treatment, and other health conditions, says Jack Melson, MD, a medical oncologist at VCU Massey Comprehensive Cancer Center in Richmond, Virginia.

Overall Health

Other health issues may affect survival by changing what treatments you can have, says David Braun, MD, PhD, a medical oncologist and physician scientist at Yale Cancer Center in Connecticut.

Tumor Characteristics

Survival can change based on the type of RCC and tumor you have, says Dr. Braun.

• Type Clear cell renal cell carcinoma (the most common type) may carry a lower chance of survival than other types.

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• Grade Providers grade tumors based on how their cells look under a microscope, and high-grade tumors are typically bigger and more aggressive.

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• Dedifferentation Sometimes gene mutations prompt RCC cells to change into a more primitive cell type (like stem cells), which makes them more aggressive and harder to treat.

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   This happens in about 5 to 8 percent of cases, depending on the cancer type.

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• Necrosis When a tumor grows so fast that it causes cancer cell death (necrosis), that can point to an aggressive type with a lower survival rate.

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Metastasis Locations

When cancer grows into other areas of the body (metastasizes), survival rates decrease, but where it spreads makes a difference, too, says Braun. “Areas like the liver, brain, and bone might indicate a more aggressive disease than metastasis to another site like the pancreas,” he says.

Risk Category

• Memorial Sloan Kettering Cancer Center's prediction tool
• International Metastatic Renal Cell Carcinoma Database Consortium's risk calculator

“One limitation of these models is that they do not clearly suggest how an oncologist should change treatment based on the calculated risk category,” says Melson, adding that experts are trying to develop tests that can help oncologists pick one treatment over another.

Response to Treatment

How New Treatments Affect Survival

In the past, doctors treated metastatic kidney cancer with an older form of immunotherapy called cytokines, which didn’t work well for many, says Braun. “Next came the era of targeted therapies, specifically tyrosine kinase inhibitors targeting blood vessel formation,” he says. These helped people live longer but rarely led to long-term tumor control or a cure, Braun adds.

Questions to Ask Your Doctor

Your oncologist can give you an estimate of your personalized survival, help you understand your treatment options, and offer suggestions on how to enjoy the best quality of life possible throughout the process.

• Where has my cancer spread, and what does that mean for my survival?
• What is my tumor grade and type?
• What tests will I need in the near future?
• Am I eligible for any testing (like biomarker or molecular) that will help you target my cancer?
• Would you recommend that I get a second opinion, and can you refer a provider?
• Are any clinical trials a good fit for me?

“How long any one person with a cancer diagnosis will live is impossible to know,” says Melson, but your doctor can guide your expectations. “Oncologists also recognize that quality of life is often as important — if not more important — to an individual than quantity of life,” Melson says.

The Takeaway

• Getting diagnosed with metastatic renal cell carcinoma may feel scary, and survival rates can be confusing, but your oncologist can offer you a more personalized prediction.
• Metastatic kidney cancer survival depends on your tumor type, where it has spread, how you respond to treatment, and other medical conditions.
• New treatments have increased survival time with metastatic RCC, and you can ask your provider about medications and clinical trials available to you.