Chae Eun Jin, Kim Jeong Kon, Kim Soo Hyun, Bae Sang-Jin, Cho Kyoung-Sik
Department of Radiology, Asan Medical Center, University of Ulsan, 388-1 Poongnap-dong, Songpa-gu, Seoul, 138-736, Korea.
Radiology. 2005 Jan;234(1):189-96. doi: 10.1148/radiol.2341031733. Epub 2004 Nov 10.
To retrospectively analyze the recurrence patterns of renal cell carcinoma (RCC) and the factors affecting tumor recurrence.
The institutional review board approved this study; patient informed consent was not required. There were 162 men (mean age, 54 years +/- 13 [standard deviation]) and 32 women (mean age, 56 years +/- 11) who had undergone complete surgical resection of RCC. Mean follow-up period was 45 months (range, 7-92 months). In consensus, two radiologists determined the presence or absence of tumor recurrence and recorded the time and sites of tumor recurrence. The relationships between tumor recurrence and tumor factors, including greatest diameter (> or =5 cm or <5 cm), T stage, N stage, stage group, histologic subtype, and nuclear grade, were evaluated by using Kaplan-Meier statistics.
Tumor recurred in 41 (21%) patients. The mean time of tumor recurrence was 17 months (range, 3-50 months). Tumor recurred within 2 years after surgery in 34 (83%) patients. Tumor recurrence sites included lung (n = 29), bone (n = 13), the nephrectomy site (n = 7), brain (n = 6), liver (n = 5), mediastinal lymph nodes (n = 5), the contralateral kidney (n = 4), and the neck muscles (n = 2). The recurrence rate was greater for tumors 5 cm or larger than for those smaller than 5 cm, greater for T3a or T3b tumors than for T1 tumors, greater for stage III tumors than for stage I tumors, and greater for tumors with a nuclear grade of 3 or 4 than for those with a nuclear grade of 1 or 2 (P < .05 for all).
RCC usually recurs within 2 years after surgery, with the lung being the most vulnerable site; greatest tumor diameter, T stage, stage group, and nuclear grade are important factors for recurrence.
回顾性分析肾细胞癌（RCC）的复发模式及影响肿瘤复发的因素。
本研究经机构审查委员会批准；无需患者知情同意。162例男性（平均年龄54岁±13[标准差]）和32例女性（平均年龄56岁±11）接受了RCC完整手术切除。平均随访期为45个月（范围7 - 92个月）。由两名放射科医生共同确定肿瘤复发情况，并记录肿瘤复发时间和部位。采用Kaplan - Meier统计学方法评估肿瘤复发与肿瘤因素（包括最大直径（≥5 cm或<5 cm）、T分期、N分期、分期组、组织学亚型和核分级）之间的关系。
41例（21%）患者出现肿瘤复发。肿瘤复发的平均时间为17个月（范围3 - 50个月）。34例（83%）患者在术后2年内出现肿瘤复发。肿瘤复发部位包括肺（n = 29）、骨（n = 13）、肾切除部位（n = 7）、脑（n = 6）、肝（n = 5）、纵隔淋巴结（n = 5）、对侧肾（n = 4）和颈部肌肉（n = 2）。直径≥5 cm的肿瘤复发率高于<5 cm的肿瘤，T3a或T3b期肿瘤的复发率高于T1期肿瘤，III期肿瘤的复发率高于I期肿瘤，核分级为3或4级的肿瘤复发率高于核分级为1或2级的肿瘤（所有P < 0.05）。
RCC通常在术后2年内复发，肺是最易受累部位；肿瘤最大直径、T分期、分期组和核分级是复发的重要因素。
