Analysis of survival rates and evaluation of prognostic factors in patients with lung metastases from renal cell carcinoma

Q4 Medicine
D. V. Semyonov, R. V. Orlova, V. I. Shirokorad, S. V. Kostritsky, N. A. Karlova
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引用次数: 0

Abstract

In patients with lung metastases from renal cell cancer (RCC), it is necessary to search for new prognostic factors influencing survival rates. Aim: To analyze survival rates and identify prognostic factors in patients with lung metastases from RCC. Material and methods. We retrospectively analyzed the data from 655 patients with lung metastases from RCC, who were treated at Moscow city oncology Hospital No. 62 (Moscow) and city clinical oncology center (Saint Petersburg) from 2006 to 2022. Of these patients, 241 (36.8 %) were classified into the intermediate prognosis group, and 278 (42.2 %) into the unfavorable prognosis group. The study investigated clinical and morphologic prognostic factors influencing survival rates in patients with lung metastases from RCC. Statistical analysis was performed using Statistica 10.0 software packages (StatSoft, USA) by constructing Kaplan-Meier curves and survival tables, building a mathematical model of survival. Results. The 3- and 5-year OS rates in patients with lung metastases from RCC (N=655) were 48 % [95 % ci 45–53 %] and 27 % [95 % ci 23–31 %], respectively, with a median OS of 34.9 months [95 % ci 30.4–37.4]. in univariate analysis, ECOG status (p<0.001), histological subtype (p<0.001), Fuhrman grade of tumor differentiation (p<0.001), type and number of metastases (p<0.001), metastases to the bones and liver (p<0.001), lymph nodes (p=0.001), prognosis according to IMDC(p<0.001), nephrectomy and metastasectomy (p<0.001) had a negative impact on OS in patients with lung metastases from RCC. In multivariate analysis, ECOG status 3.66 (2.10–6.39, p<0.001), histological subtype 1.49 (1.10–2.01, p=0.009), grade of tumor differentiation according to Fuhrman 1.54 (1.13–2.09, p=0.006), number of metastases 3.63 (1.44–9.16, p=0.006), prognosis according to IMDC2.27 (1.63–3.17, p<0.001), and nephrectomy 1.87 (1.29–2.70, p=0.001) and metastasectomy 0.69 (0.53–0.88, p=0.003) were additional factors influencing OS rates in patients with lung metastases from RCC. Conclusion. In our study, ECOG status, histologic subtype of RCC, Fuhrman grade of tumor differentiation, number of metastases, IMDC prognosis, and nephrectomy and metastasectomy were additional independent prognostic factors affecting OS in patients with lung metastases from RCC. Further studies are needed to investigate prognostic factors in patients with RCC lung metastases to improve the effectiveness of personalized treatment and survival rates.
肾细胞癌肺部转移患者生存率分析及预后因素评估
对于肾细胞癌(RCC)肺转移患者,有必要寻找影响生存率的新预后因素。目的:分析RCC肺转移患者的生存率并确定预后因素。材料与方法我们回顾性分析了2006年至2022年期间在莫斯科市第62肿瘤医院(莫斯科)和市临床肿瘤中心(圣彼得堡)接受治疗的655名RCC肺转移患者的数据。在这些患者中,有241人(36.8%)被归为预后中等组,278人(42.2%)被归为预后不良组。该研究调查了影响 RCC 肺转移患者生存率的临床和形态预后因素。使用Statistica 10.0软件包(StatSoft,美国)进行统计分析,构建Kaplan-Meier曲线和生存表,建立生存数学模型。结果在单变量分析中,ECOG状态(P<0.001)、组织学亚型(P<0.001)、肿瘤分化的Fuhrman分级(p<0.001)、转移灶的类型和数量(p<0.001)、骨和肝转移(p<0.001)、淋巴结(p=0.001)、根据IMDC的预后(p<0.001)、肾切除术和转移灶切除术(p<0.001)对RCC肺转移患者的OS有负面影响。在多变量分析中,ECOG状态3.66(2.10-6.39,p<0.001)、组织学亚型1.49(1.10-2.01,p=0.009)、根据Fuhrman的肿瘤分化等级1.54(1.13-2.09,p=0.006)、转移灶数量3.63(1.44-9.16,p=0.006)、IMDC2.27(1.63-3.17,p<0.001)、肾切除术1.87(1.29-2.70,p=0.001)和转移灶切除术0.69(0.53-0.88,p=0.003)是影响RCC肺转移患者OS率的其他因素。结论在我们的研究中,ECOG状态、RCC组织学亚型、肿瘤分化的Fuhrman分级、转移灶数量、IMDC预后、肾切除术和转移灶切除术是影响RCC肺转移患者OS的其他独立预后因素。需要进一步研究RCC肺转移患者的预后因素,以提高个性化治疗的有效性和生存率。
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来源期刊
Siberian journal of oncology
Siberian journal of oncology Medicine-Oncology
CiteScore
0.40
自引率
0.00%
发文量
117
审稿时长
8 weeks
期刊介绍: The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets
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