{"title":"高危肾癌患者肾切除术后复发的风险分层。","authors":"Taisuke Tobe, Jun Teishima, Hideto Ueki, Yusuke Shiraishi, Naoto Wakita, Yasuyoshi Okamura, Kotaro Suzuki, Yukari Bando, Takuto Hara, Tomoaki Terakawa, Koji Chiba, Akihisa Yao, Hideaki Miyake","doi":"10.1007/s10147-025-02825-y","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>To identify prognostic factors that guide adjuvant therapy decisions, we investigated factors predicting recurrence in patients with high-risk clear cell renal cell carcinoma (RCC) after nephrectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with non-metastatic, high-risk clear cell RCC who underwent radical or partial nephrectomy at our institution and affiliated centers between January 2016 and March 2024. Multivariate analysis using the Cox proportional hazards model was performed to identify clinicopathological factors associated with recurrence. On the basis of these factors, we developed a risk stratification model.</p><p><strong>Results: </strong>A total of 338 patients were included. The 5-year recurrence-free survival (RFS) rate was 54.3%. Multivariate analysis identified a body mass index of ≤ 22 kg/m<sup>2</sup> (Hazard Ratio [HR]: 2.61), rhabdoid differentiation (HR: 5.14), anemia (HR: 1.97), hypercalcemia (HR: 2.67), and C-reactive protein ≥ 0.5 mg/dL (HR: 1.72) as independent predictors of recurrence. RFS was significantly different between patients with varying numbers of risk factors: 3-year RFS rates were 22.6% for those with 3-4 factors, 47.9% for those with two, 75.5% for those with one, and 83.6% for those with none.</p><p><strong>Conclusion: </strong>We identified independent predictors of recurrence in patients with nephrectomy-treated clear cell RCC. Patients stratified according to a risk score based on these factors had different recurrence rates, suggesting that this score could assist in guiding adjuvant therapy decisions.</p>","PeriodicalId":13869,"journal":{"name":"International Journal of Clinical Oncology","volume":" ","pages":""},"PeriodicalIF":2.8000,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Risk stratification for recurrence after nephrectomy in high-risk renal cell carcinoma patients.\",\"authors\":\"Taisuke Tobe, Jun Teishima, Hideto Ueki, Yusuke Shiraishi, Naoto Wakita, Yasuyoshi Okamura, Kotaro Suzuki, Yukari Bando, Takuto Hara, Tomoaki Terakawa, Koji Chiba, Akihisa Yao, Hideaki Miyake\",\"doi\":\"10.1007/s10147-025-02825-y\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>To identify prognostic factors that guide adjuvant therapy decisions, we investigated factors predicting recurrence in patients with high-risk clear cell renal cell carcinoma (RCC) after nephrectomy.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with non-metastatic, high-risk clear cell RCC who underwent radical or partial nephrectomy at our institution and affiliated centers between January 2016 and March 2024. Multivariate analysis using the Cox proportional hazards model was performed to identify clinicopathological factors associated with recurrence. On the basis of these factors, we developed a risk stratification model.</p><p><strong>Results: </strong>A total of 338 patients were included. The 5-year recurrence-free survival (RFS) rate was 54.3%. Multivariate analysis identified a body mass index of ≤ 22 kg/m<sup>2</sup> (Hazard Ratio [HR]: 2.61), rhabdoid differentiation (HR: 5.14), anemia (HR: 1.97), hypercalcemia (HR: 2.67), and C-reactive protein ≥ 0.5 mg/dL (HR: 1.72) as independent predictors of recurrence. RFS was significantly different between patients with varying numbers of risk factors: 3-year RFS rates were 22.6% for those with 3-4 factors, 47.9% for those with two, 75.5% for those with one, and 83.6% for those with none.</p><p><strong>Conclusion: </strong>We identified independent predictors of recurrence in patients with nephrectomy-treated clear cell RCC. Patients stratified according to a risk score based on these factors had different recurrence rates, suggesting that this score could assist in guiding adjuvant therapy decisions.</p>\",\"PeriodicalId\":13869,\"journal\":{\"name\":\"International Journal of Clinical Oncology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-07-14\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"International Journal of Clinical Oncology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10147-025-02825-y\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"International Journal of Clinical Oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10147-025-02825-y","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Risk stratification for recurrence after nephrectomy in high-risk renal cell carcinoma patients.
Background: To identify prognostic factors that guide adjuvant therapy decisions, we investigated factors predicting recurrence in patients with high-risk clear cell renal cell carcinoma (RCC) after nephrectomy.
Methods: We retrospectively reviewed patients with non-metastatic, high-risk clear cell RCC who underwent radical or partial nephrectomy at our institution and affiliated centers between January 2016 and March 2024. Multivariate analysis using the Cox proportional hazards model was performed to identify clinicopathological factors associated with recurrence. On the basis of these factors, we developed a risk stratification model.
Results: A total of 338 patients were included. The 5-year recurrence-free survival (RFS) rate was 54.3%. Multivariate analysis identified a body mass index of ≤ 22 kg/m2 (Hazard Ratio [HR]: 2.61), rhabdoid differentiation (HR: 5.14), anemia (HR: 1.97), hypercalcemia (HR: 2.67), and C-reactive protein ≥ 0.5 mg/dL (HR: 1.72) as independent predictors of recurrence. RFS was significantly different between patients with varying numbers of risk factors: 3-year RFS rates were 22.6% for those with 3-4 factors, 47.9% for those with two, 75.5% for those with one, and 83.6% for those with none.
Conclusion: We identified independent predictors of recurrence in patients with nephrectomy-treated clear cell RCC. Patients stratified according to a risk score based on these factors had different recurrence rates, suggesting that this score could assist in guiding adjuvant therapy decisions.
期刊介绍：
The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.
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