Prognostic factors for survival in metastatic renal cell carcinoma: retrospective analysis from 109 consecutive patients.
Prognostic factors for survival in metastatic renal cell carcinoma: retrospective analysis from 109 consecutive patients.
复制标题
转移性肾细胞癌生存的预后因素：109 名连续患者的回顾性分析。
DOI：
10.1159/000474469
复制
发表时间：
1997
期刊：
影响因子：
23.4
通讯作者：
C. Rugarli
中科院分区：
文献类型：
--
作者：
G. Citterio;A. Bertuzzi;M. Tresoldi;L. Galli;G. Di Lucca;U. Scaglietti;C. Rugarli
客观化
转移性肾细胞癌(RCC)预示着不良的预后，但不同患者的存活率有很大差异。这项研究的目的是确定影响生存的预后因素，目的是为患者提供适当的治疗选择。
方法
我们回顾了自1988年以来我科连续收治的109例转移性肾细胞癌患者的临床资料，并考虑了从诊断到发现转移性肾癌后的存活率。单因素和多因素分析评估了年龄、性别、无病间期(DFI)、ECOG表现状态(PS)、诊断分期、分级、转移部位的数目和类型、肾切除、血中血红蛋白、肌酐、白蛋白、钙、乳酸脱氢酶(LDH)、铁蛋白、碱性磷酸酶、甘油三酯的水平对预后的影响。
结果
在我们的研究中，以下变量在单因素分析中被发现具有统计学意义(p<；0.01)：DFI、ECOG PS、诊断分期、分级、肾切除、转移部位、血血红蛋白、血清白蛋白、钙、LDH、碱性磷酸酶。事实上，在多变量分析中，只有COGPS为2-3(相对危险度1.82；p=0.003)和血液血红蛋白水平<lt；或=10g/100ml(相对危险度1.2；p=0.017)保留了作为生存不良的独立危险因素的价值。根据独立危险因素的数量，三组患者的中位生存期有显著差异(21.7vs.8.6vs.3.5月；对数等级检验：p=0.00004，p=0.04126和p=0.00047)。
结论
在转移性肾细胞癌的诊断中，表现状态差和贫血预示着我们这一系列中最糟糕的结局。这些因素可以在临床试验中对患者进行分层，并在肿瘤学实践中选择适当的治疗方案。
OBJECTIVE
Metastatic renal cell cancer (RCC) portends a bad prognosis, but survival is quite different among different patients. The objective of this study was to determine prognostic factors for survival with the aim to offer patients proper therapeutic options.
METHODS
A consecutive series of 109 metastatic RCC patients admitted to our department since 1988 was reviewed, and survival from the time of diagnosis with metastases recognition was considered. The role of age, sex, disease-free interval (DFI), ECOG performance status (PS), stage at diagnosis, grading, number and type of metastatic sites, nephrectomy, blood levels of hemoglobin, creatinine, albumin, calcium, lactate dehydrogenase (LDH), ferritin, alkaline phosphatase, triglycerides was assessed in univariate and multivariate analysis.
RESULTS
In our study, the following variables were found to be statistically significant at the univariate analysis (p < 0.01): DFI, ECOG PS, stage at diagnosis, grading, nephrectomy, sites of metastases, blood hemoglobin, serum albumin, calcium, LDH, alkaline phosphatase. Indeed, only an ECOG PS of 2-3 (relative risk 1.82; p = 0.003) and blood hemoglobin levels < or = 10 g/100 ml (relative risk 1.20; p = 0.017) retained their value as independent risk factors for poor survival at multivariate analysis. According to the number of independent risk factors, three groups of patients were identified, with significantly different median survival (21.7 vs. 8.6 vs. 3.5 months; log-rank test: p = 0.00004, p = 0.04126 and p = 0.00047, respectively).
CONCLUSIONS
Poor performance status and anemia at diagnosis of metastatic RCC predict the worst outcome in our series. These factors could be taken into account to stratify patients in clinical trails and to select the proper treatment option in oncological practice.