Pre-operative risk stratification for cancer-specific survival in patients with renal cell carcinoma with venous involvement who underwent nephrectomy.

Autor:	Nakayama T; Department of Urology, Tokyo Medical and Dental University., Saito K; Department of Urology, Tokyo Medical and Dental University kz-saito.uro@tmd.ac.jp., Fujii Y; Department of Urology, Tokyo Medical and Dental University., Abe-Suzuki S; Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan., Nakanishi Y; Department of Urology, Tokyo Medical and Dental University., Kijima T; Department of Urology, Tokyo Medical and Dental University., Yoshida S; Department of Urology, Tokyo Medical and Dental University., Ishioka J; Department of Urology, Tokyo Medical and Dental University., Matsuoka Y; Department of Urology, Tokyo Medical and Dental University., Numao N; Department of Urology, Tokyo Medical and Dental University., Koga F; Department of Urology, Tokyo Medical and Dental University., Kihara K; Department of Urology, Tokyo Medical and Dental University.
Jazyk:	angličtina
Zdroj:	Japanese journal of clinical oncology [Jpn J Clin Oncol] 2014 Aug; Vol. 44 (8), pp. 756-61. Date of Electronic Publication: 2014 May 28.
DOI:	10.1093/jjco/hyu072
Abstrakt:	Objective: The aim of this study is to identify the pre-operative prognostic factors and create a risk stratification model for patients with renal cell carcinoma with extension into the renal vein or inferior vena cava. Methods: The study cohort included 61 patients with renal cell carcinoma extending into the renal vein or inferior vena cava that underwent operations between 1993 and 2012. Cancer-specific survival rates were estimated, and univariate and multivariate analyses were carried out to determine the prognostic factors. A simple risk stratification model was developed for these patients. Results: The median follow-up period of the current patient cohort was 33.7 months. Their 1, 3 and 5-year cancer-specific survival were 89, 70 and 65%, respectively. On multivariate analysis, the level of tumor thrombus extension (extension into the supradiaphragm), presence of distant metastasis and elevation of lactate dehydrogenase and C-reactive protein were independent negative prognostic factors for cancer-specific survival. Cancer-specific survival rates were clearly discriminated by the stratification according to the scoring model (P < 0.001). The concordance index of the new model was 0.80. Conclusions: We demonstrated a simple risk stratification model with four pre-operative independent prognostic factors for patients with renal cell carcinoma with venous involvement. This may be a useful decision-making model in the management of such patients. (© The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)
Databáze:	MEDLINE
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