Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma
Effect of papillary and chromophobe cell type on disease-free survival after nephrectomy for renal cell carcinoma
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DOI：
10.1007/bf02524349
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发表时间：
2004-01-01
影响因子：
3.7
通讯作者：
Russo, P
中科院分区：
文献类型：
--
作者：
Beck, SDW;Patel, MI;Russo, P
背景：传统上，肾皮质肿瘤的临床分期并未评估组织学亚型对生存的潜在影响。有证据表明，传统的透明细胞肾细胞癌（RCC）和非传统的透明细胞RCC（嫌色细胞和乳头状）有不同的转移潜力。使用一个大型的肾肿瘤数据库，我们研究了肿瘤组织学转移和患者survival.Methods的模式的影响：非转移性肾皮质肿瘤进行部分或根治性肾切除术的所有患者被确定从1989年7月至2002年7月之间的肾肿瘤数据库。结果：1057例患者中，常规透明细胞肾细胞癌794例，乳头状肾细胞癌157例，嫌色细胞肾细胞癌106例。95例常规透明细胞肾细胞癌、9例乳头状肾细胞癌和6例嫌色细胞肾细胞癌发生转移，中位随访时间分别为34.6、43.0和33.2个月。使用对数秩分析，嫌色细胞和乳头状肾细胞癌与5年无病生存率的改善相关（分别为P = 0.009和0.015）。多变量分析显示肿瘤大小，阶段，和嫌色细胞组织学作为疾病progress.Conclusions的重要变量：肾皮质肿瘤有不同程度的转移潜力不同的组织学亚型。传统的透明细胞肾细胞癌，其中包括三分之二的肾皮质肿瘤表现为局限性疾病，有一个不太有利的结果相比，乳头状和嫌色细胞肾细胞癌。控制大小和阶段，嫌色，而不是乳头状，RCC是一个显着的变量相比，传统的透明细胞RCC的疾病进展。了解肾皮质肿瘤的组织学亚型对于预测预后、定制随访策略和设计临床试验至关重要。
Background: The clinical staging of renal cortical tumors traditionally has not evaluated the potential effect of histological subtypes on survival. Evidence suggests that conventional clear cell renal cell carcinoma (RCC) and nonconventional clear cell RCC (chromophobe and papillary) have different metastatic potential. Using a large renal tumor database, we examined the effect of tumor histology on the pattern of metastasis and patient survival.Methods: All patients with nonmetastatic renal cortical tumors undergoing partial or radical nephrectomy were identified from a renal tumor database between July 1989 and July 2002. Kaplan-Meier and Cox regression tests were used for statistical analysis.Results: Analysis revealed 1057 patients: 794 with conventional clear cell RCC, 157 with papillary RCC, and 106 with chromophobe RCC. Metastasis occurred in 95 conventional clear cell RCC, 9 papillary RCC, and 6 chromophobe RCC with a median follow-up of 34.6, 43.0, and 33.2 months, respectively. Using log-rank analysis, chromophobe and papillary RCC were associated with an improved disease-free survival at 5 years (P = .009 and .015, respectively). Multivariate analysis revealed tumor size, stage, and chromophobe histology as significant variables for disease progression.Conclusions: Renal cortical tumors have distinct histological subtypes with varying degrees of metastatic potential. Conventional clear cell RCC, which comprises two thirds of renal cortical tumors presenting with localized disease, has a less favorable outcome when compared with papillary and chromophobe RCC. Controlling for size and stage, chromophobe, and not papillary, RCC was a significant variable for disease progression compared with conventional clear cell RCC. Knowledge of renal cortical tumor histological subtype is critical for projecting prognosis, tailoring follow-up strategies, and designing clinical trials.