Renal cell carcinoma in young and old patients--is there a difference?
Renal cell carcinoma in young and old patients--is there a difference?
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DOI：
10.1016/j.juro.2008.06.037
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发表时间：
2008-10
期刊：
影响因子：
--
通讯作者：
Touijer K
中科院分区：
文献类型：
--
作者：
Thompson RH;Ordonez MA;Iasonos A;Secin FP;Guillonneau B;Russo P;Touijer K
肾细胞癌（RCC）在40岁以下的患者中很少见，文献中关于表现和结局的数据相互矛盾。我们回顾了我们的经验，年轻的肾细胞癌患者比较他们与老年同行。我们在1989年至2005年期间对1,720例年龄在18-79岁之间的RCC患者进行了部分或根治性肾切除术。根据年龄对患者进行分组，并进行结局分析。在1，720例RCC患者中，年龄<40岁、40-59岁和60-79岁的患者分别为89例（5%）、672例（39%）和959例（56%）。在性别、肿瘤大小、TNM分期或多灶性方面，年龄组无显著差异。然而，<40岁的患者更有可能出现症状性肿瘤（p=0.028）。此外，不同年龄的组织学差异显著（p<0.001）;嫌色细胞组织学随年龄增加而减少，而乳头状组织学随年龄增加。尽管每个年龄组的肿瘤大小相似，但接受肾部分切除术的患者比例随着年龄的增长而下降; 49%的<40岁患者接受肾部分切除术，而40-59岁和60-79岁患者分别为35%和30%（p<0.001）。中位随访时间为2.6年（范围0-14.5），我们没有观察到不同年龄的癌症特异性生存率存在显着差异（p=0.17）。年轻的肾细胞癌患者更有可能有症状的肿瘤与嫌色细胞组织学，但预后似乎相似的年龄组。老年患者更有可能接受根治性肾切除术治疗，这需要仔细审查目前的临床实践。
Renal cell carcinoma (RCC) is rare in patients <40 years old and conflicting data regarding presentation and outcome are present in the literature. We reviewed our experience with young RCC patients comparing them to older counterparts. We identified 1,720 patients 18-79 years old managed with partial or radical nephrectomy for RCC between 1989 and 2005. Patients were grouped according to age and outcome analyses were conducted. Among the 1,720 RCC patients, there were 89 (5%), 672 (39%), and 959 (56%) patients aged <40, 40-59, and 60-79 years old, respectively. There were no significant differences in sex, tumor size, TNM stage, or multifocality by age group. However, patients <40 years old were significantly more likely to present with symptomatic tumors (p=0.028). Additionally, there were significant differences in histology by age (p<0.001); chromophobe histology decreased while papillary histology increased with age. Despite similar tumor sizes in each age group, the percentage of patients treated with partial nephrectomy declined with age; 49% of patients <40 years old were treated with partial nephrectomy compared with 35% and 30% of patients aged 40-59 and 60-79 years old, respectively (p<0.001). With a median follow-up of 2.6 years (range 0-14.5), we did not observe a significant difference in cancer-specific survival according to age (p=0.17). Younger RCC patients are more likely to have symptomatic tumors with chromophobe histology although prognosis appears similar across age groups. Older patients are more likely to be treated with radical nephrectomy and this requires careful scrutiny for current clinical practice.
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影响因子：
168.9
作者：
DELAROCHEFORDIERE, A;ASSELAIN, B;FOURQUET, A
通讯作者：
FOURQUET, A
影响因子：
2.1
作者：
Goetzl, MA;Desai, M;McKiernan, JM
通讯作者：
McKiernan, JM
影响因子：
6.6
作者：
Thompson, R. Houston;Boorjian, Stephen A.;Blute, Michael L.
通讯作者：
Blute, Michael L.
影响因子：
51.1
作者：
Huang, William C.;Levey, Andrew S.;Rosso, Paul
通讯作者：
Rosso, Paul
影响因子：
6.6
作者：
Gillett, MD;Cheville, JC;Blute, ML
通讯作者：
Blute, ML