Natural history and clinical outcome of sporadic renal cortical tumors diagnosed in the young adult
Natural history and clinical outcome of sporadic renal cortical tumors diagnosed in the young adult
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DOI：
10.1016/j.urology.2003.08.020
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发表时间：
2004-01-01
期刊：
影响因子：
2.1
通讯作者：
McKiernan, JM
中科院分区：
文献类型：
--
作者：
Goetzl, MA;Desai, M;McKiernan, JM
目标。确定年龄小于40岁的散发性肾皮质肿瘤（RCT）患者（年轻患者[YP]组）的自然病史，并将这些患者的自然病史与更典型的老年患者（OP）的RCT进行比较。我们回顾了我们的数据库，确定了34例（年龄小于40岁，中位年龄35岁）接受手术的散发性随机对照试验。YP组的结果比较了100例41 - 85岁（中位65岁）的患者。我们拟合Cox比例风险模型来检验发病年龄与复发风险之间的关系。YP组中位肿瘤大小为3.8 cm（范围0.6 ~ 19），OP组中位肿瘤大小为5.0 cm（范围0.9 ~ 22;P = 0.225）。YP组和OP组偶然发现肿瘤的比例分别为51%和56% （P = 0.65）。两组间肾部分切除术的频率无差异（35% YP和30% OP， P = 0.55）。恶性组织学亚型的发生频率在两组间无显著差异（P = 0.439）。在YP组中，只有较大的肿瘤大小（风险比1.23,95%可信区间1.02 ~ 1.50,P = 0.034）与复发风险增加有统计学意义。与OP组相比，YP组复发的可能性没有增加或减少（风险比0.79,95%可信区间0.22 ~ 2.85,P = 0.72）。YP组和OP组5年无病生存率分别为73%和80% （P = 0.23）。YP组和OP组5年疾病特异性生存率分别为85%和84% （P = 0.88）。我们的研究结果表明，随机对照试验的自然史在年轻和老年患者中是相似的。与老年患者相比，年轻患者复发的可能性既没有增加，也没有减少。(C) 2004爱思唯尔公司
Objectives. To determine the natural history of patients younger than 40 years (young patient [YP] group) who are diagnosed with a sporadic renal cortical tumor (RCT) and to compare the natural history of these patients with the more typical older patient (OP) with RCT.Methods. We reviewed our database and identified 34 patients (younger than 40 years old, median age 35) who underwent surgery for a sporadic RCT. The YP group outcomes were compared with 100 patients between 41 and 85 years (median 65). We fit a Cox proportional hazards model to examine the relationship between age at presentation and recurrence risk.Results. The median tumor size in the YP group was 3.8 cm (range 0.6 to 19) and in the OP group was 5.0 cm (range 0.9 to 22; P = 0.225). Tumors were discovered incidentally in 51% and 56% of the YP and OP groups, respectively (P = 0.65). The frequency of partial nephrectomy did not differ between the two groups (35% YP and 30% OP, P = 0.55). The frequency of malignant histologic subtypes did not differ between the groups (P = 0.439). In the YP group, only larger tumor size (hazard ratio 1.23, 95% confidence interval 1.02 to 1.50, P = 0.034) was associated with a statistically significant increased risk of recurrence. Those in the YP group were not more or less likely to develop recurrence than those in the OP group (hazard ratio 0.79, 95% confidence interval 0.22 to 2.85, P = 0.72). The 5-year disease-free survival rate was 73% and 80% in the YP and OP groups, respectively (P = 0.23). The 5-year disease-specific survival rate was 85% and 84% in the YP and OP groups, respectively (P = 0.88).Conclusions. The findings of our study indicate that the natural history of RCTs is similar in both younger and older patients. Young patients were neither more nor less likely to develop recurrence compared with their older counterparts. (C) 2004 Elsevier Inc.