期刊
CANCER
卷 124, 期 20, 页码 4023-4031出版社
WILEY
DOI: 10.1002/cncr.31661
关键词
kidney cancer; locally advanced renal cell carcinoma; lymph node dissection; nephrectomy; staging
类别
资金
- National Institutes for Health/National Cancer Institute [P30CA016]
- Chang Gung Memorial Hospital Institute [CMRPG3B1531]
- National Institutes of Health [P30 CA016672]
BACKGROUND: Lymph node (LN) metastases are associated with poor outcomes for patients with renal cell carcinoma (RCC). This study compared the survival outcomes of patients with stage III, node-positive disease (pT(123)N(1)M(0)) and patients with stage III, node-negative disease (pT(3)N(0)M(0)). METHODS: A database of 4652 patients with RCC of any histological subtype treated with surgery at The University of Texas MD Anderson Cancer Center from 1993 to 2012 was retrospectively assessed. A total of 115 patients with pT(123)N(1)M(0) disease, 274 patients with pT(3)N(0)M(0) disease, and 523 patients with pT(123)N(0/x)M(1) disease were included. Overall survival (OS) and cancer-specific survival (CSS) were estimated and compared between each cohort. RESULTS: Median OS and CSS times were significantly better for pT(3)N(0)M(0) patients than pT(123)N(1)M(0) patients (OS, 10.2 vs 2.4 years, P < .0001; CSS, not reached vs 2.8 years, P < .0001). Similar median OS and CSS times were noted for pT(123)N(1)M(0) and pT(123)N(0/x)M(1) patients (OS, 2.4 vs 2.4 years; P = .62; CSS, 2.8 vs 2.4 years; P = .10). In a multivariate analysis, tumor grade (hazard ratio [HR] for OS, 2.47; P < .0001; HR for CSS, 2.99; P < .0001) and pathologic LN involvement (HR for OS, 2.44; P < .0001; HR for CSS, 2.85; P < .0001) were associated with worse OS and CSS. CONCLUSIONS: Among RCC patients classified with stage III disease, those with pT(123)N(1)M(0) disease had significantly worse survival than those with pT(3)N(0)M(0) disease. OS and CSS were similar for patients with pT(123)N(1)M(0) disease and patients with pT(123)N(0/x)M(1) disease (stage IV). If validated, these findings suggest that RCC patients with nodal disease should be reclassified as having stage IV disease. (C) 2018 American Cancer Society.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据