Comparison of presentation and outcome for patients 18 to 40 and 60 to 70 years old with solid renal masses
Comparison of presentation and outcome for patients 18 to 40 and 60 to 70 years old with solid renal masses
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DOI：
10.1097/01.ju.0000158157.57981.80
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发表时间：
2005-06-01
影响因子：
6.6
通讯作者：
Blute, ML
中科院分区：
文献类型：
--
作者：
Gillett, MD;Cheville, JC;Blute, ML
目的：我们比较了18 ~ 40岁与60 ~ 70岁的肾实质性肿块患者的组织学亚型、病理特征和预后。材料和方法：我们对1970年至2000年的马约诊所肾切除术登记进行了回顾性分析，确定了124例18至40岁的患者和1例，结果：18 ~ 40岁组与60 ~ 70岁组肾脏良性实性肿块的发生率（13.7%vs10.2%）差异无统计学意义。在肾细胞癌（RCC）患者中，与老年患者相比，年轻患者更可能患有嫌色细胞RCC（13.1% vs 3.6%），而不太可能患有透明细胞RCC（70.1% vs 81.5%）。在透明细胞肾细胞癌患者中，年轻患者更可能患有pT 2b或更低的肿瘤（82.7% vs 69.9%），囊性透明细胞肾细胞癌的发生率（10.7% vs 2.2%）高于老年患者。与老年患者相比，年轻患者的癌症特异性生存率有所提高，但这种差异无统计学意义（风险比0.71，p = 0.127）。结论：我们发现，18至40岁的患者更有可能有嫌色细胞和不太可能有透明细胞肾细胞癌与60至70岁的患者相比。我们没有发现年轻患者乳头状肾细胞癌的发病率更高。与60 - 70岁的患者相比，18 - 40岁的透明细胞肾细胞癌患者的低分期和囊性肿瘤的发生率较高，这些特征已被证明具有良好的预后。这些因素可能有助于改善年轻患者的癌症特异性生存率。
Purpose: We compared histological subtype, pathological features and outcome of patients with solid renal masses who were 18 to 40 years old vs patients who were 60 to 70 years old.Materials and Methods: We conducted a retrospective review of the Mayo Clinic Nephrectomy Registry from 1970 to 2000, and identified 124 patients 18 to 40 years old and 1,067 patients 60 to 70 years old available for analysis.Results: There was no significant difference in the incidence of benign solid renal masses between patients 18 to 40 years old and those 60 to 70 years old (13.7% vs 10.2%). Among patients with renal cell carcinoma (RCC), younger patients were more likely to have chromophobe RCC (13.1% vs 3.6%) and less likely to have clear cell RCC (70.1% vs 81.5%) than older patients. Among patients with clear cell RCC, younger patients were more likely to have stage pT2b or lower tumors (82.7% vs 69.9%) and a higher incidence of cystic clear cell RCC (10.7% vs 2.2%) than older patients. Younger patients had an improved cancer specific survival compared with older patients but this difference was not statistically significant (risk ratio 0.71, p = 0.127).Conclusions: We found that patients 18 to 40 years old were more likely to have chromophobe and less likely to have clear cell RCC compared with patients 60 to 70 years old. We did not identify a higher incidence of papillary RCC in younger patients. Patients with clear cell RCC 18 to 40 years old had a higher incidence of low stage and cystic tumors compared with patients 60 to 70 years old, features which have been shown to have a favorable prognosis. These factors likely contributed to improved cancer specific survival for younger patients.