Oncologic Outcomes and Predictors in Patients with Stage PT3aNxM0 Renal Cell Carcinoma Following Radical Nephrectomy.

IF 1 Q4 UROLOGY & NEPHROLOGY
Mohammad Hossein Soltani, Mehdi Dadpour, Masoud Goodarzi, Reza Khabazian, Behzad Narouie, Nasrin Borumandnia, Mohammad Hamidi Madani
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Abstract

Objective: The objective of this study is to evaluate oncologic outcomes in patients with PT3aNxM0 renal cell carcinoma following radical nephrectomy and also to investigate these outcomes in each specific subgroup of PT3a renal cell carcinoma and to determine predictive factors of recurrence, metastasis, and mortality.

Materials and methods: In this retrospective cohort study, we included 94 patients with stage PT3a renal cell carcinoma who had undergone radical nephrectomy from 2011 to 2016. All patients who had survived had at least 60 months of follow-up. Demographic and clinical data were collected; univariable and multivariable Cox proportional hazards regression analysis was performed to identify predictors of metastasis, recurrence, and cancer-related mortality.

Results: Patients' mean age was 58.07 ± 11.17 years and 62/94 (65.9%) were male. The mean follow-up time was 48.1 ± 25.5 months. Forty-three patients (45.7%) had experienced cancer-related mortality. The mean cancer-specific survival time was 60.94 months and the mean metastasis-free and local recurrence-free survival times were 57.06 and 88.72 months, respectively. Metastasis and local recurrence had occurred in 42 (44.6%) and 4 (4.25%) patients, respectively. After performing multivariate analysis, higher nuclear Fuhrman's grade (P < .001) and simultaneous involvement of the renal vein and perinephric fat (P < .001) were found to be predictive of cancerrelated mortality. Advanced nuclear Fuhrman's grade was the only independent predictor of metastasis (P=.001).

Conclusion: Based on our results, advanced nuclear Fuhrman's grade and sarcomatoid change can independently predict mortality in patients with stage PT3aNxM0 renal cell carcinoma. Close monitoring during the follow-up period is recommended in patients with the mentioned risk factors.

Abstract Image

Abstract Image

根治性肾切除术后PT3aNxM0期肾细胞癌患者的肿瘤预后和预测因素
目的:本研究的目的是评估PT3aNxM0肾细胞癌患者在根治性肾切除术后的肿瘤学结果,并研究PT3a肾细胞癌每个特定亚组的这些结果,并确定复发、转移和死亡率的预测因素。材料和方法:在这项回顾性队列研究中,我们纳入了2011年至2016年接受根治性肾切除术的94名PT3a期肾细胞癌患者。所有存活的患者都有至少60个月的随访。收集人口统计学和临床数据;进行单变量和多变量Cox比例风险回归分析,以确定转移、复发和癌症相关死亡率的预测因素。结果:患者平均年龄为58.07±11.17岁,男性62/94(65.9%)。平均随访时间为48.1±25.5个月。有43名患者(45.7%)经历过与癌症相关的死亡率。平均癌症特异性生存时间为60.94个月,平均无转移和局部无复发生存时间分别为57.06和88.72个月。转移和局部复发分别发生在42例(44.6%)和4例(4.25%)患者中。在进行多变量分析后,发现较高的核Fuhrman分级(P<.001)和肾静脉和肾周脂肪同时受累(P<.0001)可预测癌症相关死亡率。晚期核Fuhrman分级是转移的唯一独立预测因子(P = .001)。结论:根据我们的研究结果,晚期核Fuhrman分级和肉瘤样改变可以独立预测PT3aNxM0期肾细胞癌患者的死亡率。建议对有上述危险因素的患者在随访期间进行密切监测。
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来源期刊
Turkish journal of urology
Turkish journal of urology Medicine-Urology
CiteScore
2.10
自引率
0.00%
发文量
53
期刊介绍: The aim of the Turkish Journal of Urology is to contribute to the literature by publishing scientifically high-quality research articles as well as reviews, editorials, letters to the editor and case reports. The journal’s target audience includes, urology specialists, medical specialty fellows and other specialists and practitioners who are interested in the field of urology.
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