Renal cell carcinoma and pathologic nodal disease: Implications for American Joint Committee on Cancer staging
| Autor: | Firas G. Petros, Matthew Meissner, Xuemei Wang, Kai Jie Yu, Sarp Korcan Keskin, Leonardo D. Borregales, Christopher G. Wood, Pheroze Tamboli, Cindy Gu, Surena F. Matin, Jose A. Karam |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent Databases Factual medicine.medical_treatment 030232 urology & nephrology Medical Oncology Gastroenterology Disease-Free Survival Young Adult 03 medical and health sciences 0302 clinical medicine Renal cell carcinoma Internal medicine otorhinolaryngologic diseases Humans Medicine Stage (cooking) Carcinoma Renal Cell Lymph node Societies Medical Aged Neoplasm Staging Retrospective Studies Cancer staging Aged 80 and over business.industry Hazard ratio Cancer Middle Aged Prognosis medicine.disease Survival Analysis Kidney Neoplasms United States Nephrectomy medicine.anatomical_structure Oncology Lymphatic Metastasis 030220 oncology & carcinogenesis Female business Kidney cancer |
| Zdroj: | Cancer. 124:4023-4031 |
| ISSN: | 1097-0142 0008-543X |
| DOI: | 10.1002/cncr.31661 |
| Popis: | 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 (pT123 N1 M0 ) and patients with stage III, node-negative disease (pT3 N0 M0 ). 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 pT123 N1 M0 disease, 274 patients with pT3 N0 M0 disease, and 523 patients with pT123 N0/x M1 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 pT3 N0 M0 patients than pT123 N1 M0 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 pT123 N1 M0 and pT123 N0/x M1 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 pT123 N1 M0 disease had significantly worse survival than those with pT3 N0 M0 disease. OS and CSS were similar for patients with pT123 N1 M0 disease and patients with pT123 N0/x M1 disease (stage IV). If validated, these findings suggest that RCC patients with nodal disease should be reclassified as having stage IV disease. |
| Databáze: | OpenAIRE |
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