The Difference in Prognosis between Renal Sinus Fat and Perinephric Fat Invasion for pT3a Renal Cell Carcinoma: A Meta-Analysis.
The Difference in Prognosis between Renal Sinus Fat and Perinephric Fat Invasion for pT3a Renal Cell Carcinoma: A Meta-Analysis.
复制标题
pT3a 肾细胞癌肾窦脂肪和肾周脂肪浸润预后差异的荟萃分析
DOI：
10.1371/journal.pone.0149420
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Zhou F
中科院分区：
文献类型：
--
作者：
Zhang Z;Yu C;Velet L;Li Y;Jiang L;Zhou F
背景在目前肾细胞癌（RCC）的TNM分类系统中，肾窦脂肪浸润（SFI）和肾周脂肪浸润（PFI）均被定义为T3 a，这表明两种病理结果的预后相似。然而，一些研究报告了T3 a肿瘤患者的SFI预后更差。为了比较这两种病理结果的预后（SFI与。PFI）以更全面的方式进行了荟萃分析。方法检索Medline、Embase、科克伦图书馆和Scopus数据库，从开始到2014年10月检索相关研究。使用Review Manager 5.2和STATA 11进行荟萃分析。计算合并比值比（OR）和/或风险比（HR）及95%置信区间（CI），以检查风险或风险相关性。结果共纳入6篇文献，包括1031例患者。与PFI患者相比，SFI患者的T3 a RCC患者的癌症特异性生存率（CSS）显著相关（HR：1.47，95% CI：1.19-1.83; P<0.001）。在T3 aNx/N 0 M0亚组中，SFI患者的预后也比PFI患者差（CSS，HR：1.94，95%CI：1.21-3.12; P = 0.006）。伴SFI的T3 a肾癌患者Furhman分级高，淋巴结转移、肉瘤样分化和肿瘤坏死的可能性大。主要限制是纳入的研究数量相对较少。结论pT 3a肾癌患者SFI与CSS恶化相关。然而，由于纳入的研究数量较少，需要未来大样本量的研究来进一步验证我们的发现。
Background In the current Tumour-Node-Metastasis (TNM) classification system for renal cell carcinoma (RCC), both renal sinus fat invasion (SFI) and perinephric fat invasion (PFI) are defined as T3a, suggesting that the prognosis should be similar for the two pathologic findings. Several studies, however, have reported a worse prognosis for SFI in patients with a T3a tumor. In order to compare the prognosis of these two pathologic findings (SFI versus. PFI) in a more comprehensive way, this meta-analysis was performed. Methods To identify relevant studies, Medline, Embase, Cochrane Library, and Scopus database were searched from the inception until October 2014. A meta-analysis was performed using Review Manager 5.2 and STATA 11. Pooled Odds ratio (OR) and/or hazard ratio (HR) with 95% confidence interval (CI) were calculated to examine the risk or hazard association. Results A total of 6 studies including 1031 patients qualified for analysis. T3a RCC patients with SFI were significantly associated with poor cancer specific survival(CSS) (HR: 1.47, 95% CI: 1.19–1.83; P<0.001) compared to those with PFI. In T3aNx/N0M0 subgroup, SFI patients also showed a worse prognosis than those with PFI (CSS, HR: 1.94, 95% CI: 1.21–3.12; P = 0.006). T3a RCC patients with SFI had higher Furhman grade, greater possibility of lymph node metastasis, sarcomatoid differentiation and tumour necrosis. Main limitation is the relatively small number of included studies. Conclusion The present meta-analysis suggested that SFI is associated with worse CSS in patients with pT3a RCC. However, due to the small number of included studies, future studies with a large sample size are required to further verify our findings.