Kendal Wayne S
Division of Radiation Oncology, The Ottawa Hospital Regional Cancer Center, Ottawa, Ontario, Canada.
Can J Urol. 2007 Feb;14(1):3435-42.
Leiomyosarcoma of the kidney and renal pelvis is a rare tumor that, on the basis of limited data, has been ascribed a particularly poor prognosis compared to other subtypes of renal malignancy. Here the population-based Surveillance, Epidemiology, and End Results (SEER) registry is used to study the survival of renal leiomyosarcomas.
There were 95,935 cases of invasive cancer of the kidney and renal pelvis retrieved from the SEER registry to provide 112 cases of leiomyosarcoma. Kaplan-Meier survival estimates and Cox proportional hazard models were constructed to compare the survival of leiomyosarcomas to other renal malignancies.
Leiomyosarcomas constituted 0.12% of all invasive renal malignancies. They exhibited a median overall survival of 25 months, with a 25% 5-year overall survival, and a 60% 5-year cause-specific survival. Multivariate analysis of all renal malignancies together revealed that cancer stage was the strongest predictor for overall survival followed by age, histological grade, histological subtype, tumor size, and gender. The hazard ratio for leiomyosarcoma in this analysis was intermediate compared to the other malignancies. When leiomyosarcomas were analyzed separately, the major determinants to overall survival were stage and age at diagnosis. Kaplan-Meier analysis revealed that the overall survival curve for renal leiomyosarcoma essentially superimposed that of transitional cell carcinoma, and was better than that of clear cell carcinoma. These results provide a more optimistic outlook than has been conventionally afforded to this tumor.
肾和肾盂平滑肌肉瘤是一种罕见肿瘤，基于有限数据，与其他肾恶性肿瘤亚型相比，其预后被认为特别差。本文利用基于人群的监测、流行病学和最终结果（SEER）登记系统研究肾平滑肌肉瘤的生存率。
从SEER登记系统中检索出95935例肾和肾盂浸润性癌病例，其中有112例平滑肌肉瘤。构建Kaplan-Meier生存估计和Cox比例风险模型，以比较平滑肌肉瘤与其他肾恶性肿瘤的生存率。
平滑肌肉瘤占所有肾浸润性恶性肿瘤的0.12%。其总体生存中位数为25个月，5年总体生存率为25%，5年病因特异性生存率为60%。对所有肾恶性肿瘤进行多变量分析发现，癌症分期是总体生存的最强预测因素，其次是年龄、组织学分级、组织学亚型、肿瘤大小和性别。在该分析中，平滑肌肉瘤的风险比与其他恶性肿瘤相比处于中等水平。当单独分析平滑肌肉瘤时，总体生存的主要决定因素是分期和诊断时的年龄。Kaplan-Meier分析显示，肾平滑肌肉瘤的总体生存曲线与移行细胞癌基本重叠，且优于透明细胞癌。这些结果提供了比该肿瘤传统预后更乐观的前景。
