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KMID : 0390320140240010001
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Chungbuk Medical Journal
2014 Volume.24 No. 1 p.1 ~ p.11
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Clinicopathological factors for the prediction of prognosis after nephrectomy in pT1b renal cell carcinoma
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Oh Seung-Yong
Kim Young-Won
Yoon Hyung-Yoon
Seo Sung-Pil
Lee Sang-Keun
Kim Won-Tae
Yun Seok-Joong
Lee Sang-Cheol
Kim Wun-Jae
Kim Yong-June
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Abstract
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Background: In stage T1 localized clear-cell renal cell carcinoma (RCC), radical nephrectomy (RN) or partial nephrectomy (PN) was regarded as a golden standard treatment, it had favorable outcomes after treatment. However, during follow up period, recurrences or deaths in stage T1b RCC occurred more frequently than those of in stage T1a RCC. The aim of the present study was to evaluate clinicopathological factors which were related with prognosis in T1b RCC patients.
Materials and Methods: Between 1999 and 2011, 3567 patients with RCC underwent RN or PN at 5 institutions in Korea. Of these, we evaluated 702 patients with pathologically confirmed stage T1b RCC. To estimate the clinicopathologic predictive factors [age, sex, diabetes mellitus (DM), hypertension, body mass index (BMI), European Cooperative Oncology Group performance score (ECOG-PS), the presence of symptoms, tumor size and grade, etc] for prognosis [recurrence-free survival (RFS), cancer-specific survival (CSS) and Overall survival (OS)], univariate and multivariate analyses were utilized. Kaplan-Meier method was applied to estimate survival function.
Results: Median follow-up period was 34.0 months (range 0-152 months). Recurrence, death and cancer-specific death were observed in 10.3% (72/702), 8.1% (57/702) and 3.4% (24/702), respectively. Univariate and multivariate analyses revealed that various factors were independent predictive factors for RFS (DM, tumor size, Fuhrman grade), CSS (age, BMI, DM, tumor size) and OS (age, BMI, ECOG-PS, tumor size).
Conclusions: This study reveals that various clinicopathological factors are independent predictive factors for prognosis in localized RCC. Our findings suggest that early detection of recurrence via active follow-up in T1b RCC patients with high risk factors after surgery will contribute for the improvements of survival.
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KEYWORD
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renal cell carcinoma, prognosis, stage T1b, survival
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