Age at Diagnosis is an Independent Predictor of Small Renal Cell Carcinoma Recurrence-Free Survival
Age at Diagnosis is an Independent Predictor of Small Renal Cell Carcinoma Recurrence-Free Survival
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DOI：
10.1016/j.juro.2009.04.013
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发表时间：
2009-08-01
影响因子：
6.6
通讯作者：
Kim, Choung-Soo
中科院分区：
文献类型：
--
作者：
Jeong, In Gab;Yoo, Chang Hee;Kim, Choung-Soo
目的：诊断时年龄对肾细胞癌患者预后的影响存在争议。我们调查了年龄之间的关系，在诊断和疾病复发后，在手术patients with small renal cell carcinoma.Materials and Methods：在1989年和2005年之间，在我们的机构490肾细胞癌4 cm或更小的1,196例接受根治性手术的肾细胞癌患者被纳入我们的研究。根据诊断时的年龄将患者分为3个亚组，包括93例40岁或以下，253例41至60岁，144例60岁以上。结果：随访期间，共有17例（3.5%）患者复发，9例（1.8%）死于转移性肾细胞癌。较高的Fuhrman核分级与诊断时年龄较大相关（p = 0.001）。组织学亚型与年龄类别相关（p = 0.016）。5年和10年的总无复发生存率分别为97.2%和92.4%。40岁或以下患者的10年无复发生存率为100%，41至60岁患者为95.7%，60岁以上患者为79.0%（p = 0.002）。多变量分析显示，诊断时的年龄和Fuhrman分级独立预测无复发生存率（p = 0.027，
Purpose: Controversy exists as to the influence of age at diagnosis on prognosis in patients with renal cell carcinoma. We investigated the relationship between age at diagnosis and disease recurrence after surgery in patients with small renal cell carcinoma.Materials and Methods: Of the 1,196 patients who underwent curative surgery for renal cell carcinoma between 1989 and 2005 at our institution 490 with renal cell carcinoma 4 cm or less were included in our study. Patients were stratified into 3 subgroups according to age at diagnosis, including 40 years or less in 93, 41 to 60 years in 253 and greater than 60 years in 144. Clinical and pathological variables at diagnosis were compared and survival analysis was performed.Results: A total of 17 patients (3.5%) experienced disease recurrence and 9 (1.8%) died of metastatic renal cell carcinoma during followup. Higher Fuhrman nuclear grade was associated with older age at diagnosis (p = 0.001). Histological subtypes were associated with age categories (p = 0.016). The overall recurrence-free survival rate was 97.2% and 92.4% at 5 and 10 years, respectively. The 10-year recurrence-free survival rate was 100% for patients 40 years old or younger, 95.7% for those 41 to 60 years old and 79.0% for those older than 60 years (p = 0.002). Multivariate analysis revealed that age at diagnosis and Fuhrman grade independently predicted recurrence-free survival (p = 0.027 and