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A comprehensive prognostic stratification for patients with metastatic renal clear cell carcinoma

Authors
 Kang Su Cho  ;  Young Deuk Choi  ;  Se Joong Kim  ;  Chun Il Kim  ;  Byung Ha Chung  ;  Do Hwan Seong  ;  Dong Hyeon Lee  ;  Jin Seon Cho  ;  In Rae Cho  ;  Sung Joon Hong 
Citation
 Yonsei Medical Journal, Vol.49(3) : 451-458, 2008 
Journal Title
 Yonsei Medical Journal 
ISSN
 0513-5796 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Renal Cell/pathology ; Carcinoma, Renal Cell/therapy* ; Combined Modality Therapy ; Disease-Free Survival ; Female ; Humans ; Immunotherapy/methods ; Kidney Neoplasms/pathology ; Kidney Neoplasms/therapy* ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Staging ; Nephrectomy/methods ; Prognosis ; Retrospective Studies
Keywords
Carcinoma ; renal cell ; neoplasm metastasis ; nephrectomy ; immunotherapy ; prognosis
Abstract
PURPOSE: To develop a reliable prognostic model for patients with metastatic renal cell carcinoma (RCC) based on features readily available in common clinical settings. PATIENTS AND METHODS: A total of 197 patients with RCC who underwent nephrectomy and immunotherapy from 1995 to 2004 were retrospectively reviewed. Their mean age was 55.1+/-11.8 yrs (24-83yrs) and mean survival time from metastasis was 22.6+/-20.2mos (3-120mos). The impact of 24 clinicopathological features on disease specific survival was investigated. RESULTS: On univariate analysis, constitutional symptoms, sarcomatoid differentiation, tumor necrosis, multiple primary lesions, liver metastasis, Eastern Cooperative Oncology Group Performance Status (ECOG-PS), thrombocytosis, alkaline phosphatase, hematocrit, T stage, N stage, and nuclear grade had significant influence on survival (p<0.05). Multivariate analysis revealed the following features associated with survival: sarcomatoid differentiation [hazard ratio (HR)=2.99, p<0.001], liver metastasis (HR=2.09, p=0.002), ECOG-PS (HR=1.95, p= 0.005), N stage (HR=1.94, p=0.002), and number of metastatic sites (HR=1.76, p=0.003). An individual prognostic score was defined as the sum of the weight of these features. According to prognostic scores, patients could be subdivided into 3 groups: low risk (score 0), intermediate risk (score 1 or 2), and high risk (score> or =3). CONCLUSION: A comprehensive prognostic stratification model was developed to predict survival and stratify patients for prospective clinical trials
Files in This Item:
T200800345.pdf Download
DOI
10.3349/ymj.2008.49.3.451
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Urology (비뇨의학교실) > 1. Journal Papers
Yonsei Authors
Chung, Byung Ha(정병하) ORCID logo https://orcid.org/0000-0001-9817-3660
Cho, Kang Su(조강수) ORCID logo https://orcid.org/0000-0002-3500-8833
Choi, Young Deuk(최영득) ORCID logo https://orcid.org/0000-0002-8545-5797
Hong, Sung Joon(홍성준) ORCID logo https://orcid.org/0000-0001-9869-065X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/106501
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