국소 신세포암으로 근치적 신적출술을 시행 받은 환자에서 술전 증상의 예후적 중요도

Abstract

Purpose We investigated the relationship of the pre-operative symptoms to the other clinicopathologic factors that are known to be significant prognostic indicators for patients with renal cell carcinoma.

Materials and Methods Of the 398 patients who underwent an operation for renal cell carcinoma between March 1998 and May 2004, we retrospectively reviewed the clinical records of the 293 who were diagnosed and operated on for localized renal cell carcinoma. The patients were divided into three groups according to their pre-operative clinical symptoms. We then evaluated the patients' characteristics, the pathological factors such as the cell type, tumor size, nuclear grade, the pathological T stage, tumor necrosis, the presence of a sarcomatoid component and multifocality by using ANOVA analysis. The overall survival was estimated using the Kaplan-Meier method and the log-rank test.

Results Of the 293 cases, 118 (40.3%) were in the symptomatic group and 175 (59.7%) were in the asymptomatic groups. There was significant difference in the age, tumor size, the pathological T stage and tumor necrosis between the groups. There was a significant difference in the survival rates between the groups (p<0.001).

Conclusions Preoperative symptoms are important prognostic factors for patients with localized renal cell carcinoma. Therefore, determining the more specified symptoms is required for separating the groups with different survival after radical nephrectomy.