影响转移性肾细胞癌患者总体生存的因素:1例Dokuz eyyl大学内科肿瘤诊所

M. Uzun, E. Caliskan Yildirim, H. Semiz, F. Ekinci, B. Demi̇r, A. Erdoğan, A. Karaoglu
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摘要

目的:尽管有许多新一代的治疗方法,但众所周知,迄今为止用于预后非常差的转移性肾细胞癌(mRCC)患者的预后标志物并不能准确地确定每个患者的预后。因此,对预后生物标志物的研究仍在继续。本研究旨在探讨治疗前生化参数对mRHC患者肿瘤预后的影响。材料和方法:我们回顾性评估了90例mRCC患者的临床、病理、生存特征和影响生存的因素,这些患者在我们诊所诊断时为转移性(4期)或局部(1-3期),接受了根治性肾切除术,并在随访期间复发。对患者的人口学、临床病理及治疗特点进行描述性统计分析。结果:女性占21.2%,男性占78.8%。女性和男性的中位OS(总生存期)没有差异。诊断时转移患者的中位OS持续时间有统计学意义(p=0.001)。诊断时转移患者的中位生存期为36.2个月,随访时复发患者的中位生存期为90.4个月。随着碱性磷酸酶/白蛋白(ALP/ALB)比值的升高,存活率降低(p=0.038)。而CRP/ALB比值为0.072的中位OS (AUC.630 p=0.046 cut off:0.072)。结论:已确定CRP/ALB比值是决定预后的生物标志物。我们建议对一线靶向治疗后出现进展的患者进行免疫治疗。今天,预后在mRCC的治疗决策中变得尤为重要,我们认为我们的研究将为寻找新的预后标志物提供启示。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Examination of Factors Affecting General Survival in Patients with Metastatic Renal Cell Cancer: A Case of Dokuz Eylül University Medical Oncology Clinic
Aim: Despite many new generation treatments, it is known that the prognostic markers used to date in patients with metastatic renal cell carcinoma (mRCC), who have a very poor prognosis, can not accurately determine the prognosis in every patient. Therefore, the search for prognostic biomarkers continues. In this study, it was aimed to investigate the effect of pre-treatment biochemical parameters on oncological outcomes in mRHC patients. Material and Methods: We retrospectively evaluated the clinical, pathological, survival characteristics and factors affecting survival of 90 mRCC patients who were metastatic (stage 4) or local (stage 1-3) at the time of diagnosis in our clinic, who underwent radical nephrectomy and relapsed during follow-up. Descriptive statistical analyzes of patients' demographic, clinicopathological and treatment characteristics were performed. Results: 21.2% of the patients were female and 78.8 % were male. There was no difference in median OS (overall survival) between women and men. The median OS duration was statistically significantly lower in patients with metastasis at the time of diagnosis (p=0.001). While the median OS was 36.2 months in metastatic patients at the time of diagnosis, the median OS was 90.4 months in patients with recurrence at follow-up. As the ratio of alkaline phosphatase/Albumin (ALP/ALB) increased, survival decreased (p=0.038). While the median OS of those with a CRP/ALB ratio of 0.072 (AUC.630 p=0.046 cut off:0.072). Conclusion: It has been determined that the CRP/ALB ratio is a biomarker that determines the prognosis. We recommend immunotherapy in patients who progress after first-linetargettherapy. Today, prognosis has become important especially in the treatment decision of mRCC, and we think that our study will shedlight on the search for new prognostic markers.
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