Chemotherapy, Immunotherapy, and Surgery Should be Optimal Treatment Choices of Metastatic Sarcomatoid Renal Cell Carcinoma

Abstract Background: Sarcomatoid renal cell carcinoma (sRCC) is aggressive and with a poor prognosis. The therapeutic strategy of sRCC is unclear. We aim to evaluate the effectiveness of chemotherapy on sRCC and investigate the potential remedy to fight the sRCC. Methods: Patient information was derived from US Surveillance, Epidemiology, and End Results (SEER) database, and the demographic and clinical characteristics as variables were adopted. We apply log-rank to generate Kaplan–Meier survival curve. We established a nomogram by Cox proportional hazard model and apply the concordance index (C-index) and receiver-operating characteristic (ROC) to verify the quality of the model. Results: 809 patients were collected from SEER database. There are six independent prognostic factors, including age, sex, T stage, N stage, surgery, chemotherapy, that were employed to establish a prognostic model. The C-index of the model was 0.696. Tissue microarray (TMA) results suggested that programmed cell death ligand 1(PD-L1) was highly expressed in sRCC patients. Conclusions: Patients who have metastatic disease in sRCC can benefit from chemotherapy and surgery. Immunotherapy is promising to treat sRCC and should lunch a clinical trial at the current stage.