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KMID : 1001020070050030116
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Korean Journal of Urological Oncology
2007 Volume.5 No. 3 p.116 ~ p.121
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Surgical Outcome of the Patients with Renal Cell Carcinomas: Single Center Experience for 17 Years
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Yoo Chang-Hee
Hong Bum-Sik
Hong Jun-Hyuk
Ahn Tai-Young
Kim Choung-Soo
Ahn Han-Jong
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Abstract
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Purpose: We analyzed the clinicopathological feature, surgical outcomes, prognostic factors and survival of patients with renal cell carcinoma(RCC) to evaluate several debated issues about RCCs.
Materials and Methods : We reviewed the medical records of 1,096 sporadic single solid RCCs who were diagnosed after surgical treatment between 1989 and 2005. The mean age at the time of diagnosis was 54.0(10-84) years and 73.3% were male. Mean follow-up was 57.2 months.
Results:Mean 5-year cancer-specific survival(CSS) rates were as follows: pT1a-97.2%, pT1b-93.2%, pT2-83.6%, pT3a-63.5%, pT3b-52.5%, and pT4-42.3%. The survivals in the case of lymph node involvement were pN1-45.0% and pN2-27.7%. The CSS of RCCs with synchronous metastasis was 21.9%. Optimal cutoff point of tumor size between pT1 and pT2 was 6.0cm in diameter. Good prognosis was shown in sequence of chromophobe, conventional, and papillary RCC. Among the pT3a RCCs, 5 cases had adrenal involvement and their median survival was 26.2 months. The patients with pT3c RCCs showed median survival of 15.1 months. Among the patients with pTanyNanycM0 RCCs, mean 5-year recurrence-free survival rates were as follows: pT1a-97.0%, pT1b-90.8%, pT2-86.1%, pT3a-70.7%, pT3b-43.8%, and pT4-20.3%. The location of the thrombi head in renal vein or inferior vena cava did not impact on survival. Synchronous lung metastasis showed similar pronosis with other organ metastasis.
Conclusions : pT3a RCCs with adrenal gland invasion and pT3c RCCs had very poor prognosis. The location of tumor thrombi and initial metastatic site had no impact on survival. Papillary RCC showed poorer prognosis than conventional RCC.
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KEYWORD
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Renal cell carcinoma, Survival, Prognosis
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