Clinical Characteristics and Outcomes of Patients With Recurrence 5 Years After Nephrectomy for Localized Renal Cell Carcinoma
Clinical Characteristics and Outcomes of Patients With Recurrence 5 Years After Nephrectomy for Localized Renal Cell Carcinoma
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DOI：
10.1016/j.juro.2010.09.100
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发表时间：
2011-02-01
影响因子：
6.6
通讯作者：
Russo, Paul
中科院分区：
文献类型：
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作者：
Adamy, Ari;Chong, Kian Tai;Russo, Paul
目的：我们分析了复发性肾细胞癌患者的特点5年或以后肾切除术后，并确定复发后生存的预测因素。材料和方法：从1989年7月至2008年10月，共2,368例肾切除术，临床局部，单侧肾细胞癌在我们的机构。256例复发患者中44例为术后5年或5年以上复发。我们比较了5年前与5年后复发患者的临床病理特征。根据纪念斯隆-凯特琳癌症中心风险评分、复发症状、膀胱切除术、肿瘤直径、复发分期和部位评估复发后的生存率。结果：晚期复发患者的症状往往较少，肿瘤较小（中位值8.5 vs 7 cm），侵袭性疾病较轻（PT 1为18% vs 39%）。复发后的中位总生存期为6.1年。28例有良好风险患者的5年生存率为85%，10例中度风险患者的5年生存率为14%（log rank p
Purpose: We analyzed characteristics in patients with recurrent renal cell carcinoma 5 years or later after nephrectomy and determined predictors of survival after recurrence.Materials and Methods: From July 1989 to October 2008 at total of 2,368 nephrectomies were done for clinically localized, unilateral renal cell carcinoma at our institution. Of 256 patients with disease recurrence 44 had recurrence 5 years or more after nephrectomy. We compared clinicopathological characteristics in patients with disease recurrence before vs after 5 years. Survival from time of recurrence was assessed based on Memorial Sloan-Kettering Cancer Center risk score, symptoms at recurrence, metastasectomy, tumor diameter, and recurrence stage and site.Results: Patients with late recurrence tended to have fewer symptoms at presentation, smaller tumors (median 8.5 vs 7 cm) and less aggressive disease (pT1 in 18% vs 39%). Median overall survival was 6.1 years from time of recurrence. Five-year actuarial survival was 85% in 28 patients at favorable risk and 14% in 10 at intermediate risk (log rank p