Jung Eun-Jung, Lee Hyun Ju, Kwak Cheol, Ku Ja Hyeon, Moon Kyung Chul
Department of Pathology, Medical Research Center, Seoul National University College of Medicine, Seoul, Korea.
Urology. 2009 Jan;73(1):137-41. doi: 10.1016/j.urology.2008.08.460. Epub 2008 Oct 31.
To clarify the clinicopathologic features and prognosis of renal cell carcinoma (RCC) in young adults. The features of RCC in young adults have been reported, but the results have been conflicting.
The data from 619 patients with RCC were analyzed. The patients were divided into 2 groups according to age at diagnosis, </=55 or >55 years of age. The clinicopathologic parameters were compared, and a survival analysis was performed.
Younger patients were more likely to have a lower disease stage (P < .001), lower nuclear grade (P = .018), and smaller tumor size (P = .005) and a greater 5-year cancer-specific survival rate (P < .001) than older patients. Young age was a favorable prognostic factor for cancer-specific survival of clear cell RCC (P < .001). On multivariate analysis, young age was independently associated with a longer cancer-specific survival rate of clear cell RCC (P = .003). In addition, the prognostic implication of age differed between low (I or II) and high (III or IV) stage tumors. In low-stage clear cell RCC, young age was significantly associated with prolonged cancer-specific survival on univariate (P < .001) and multivariate (P = .007) analyses, but not in high-stage clear cell RCC (P = .906).
RCC in patients <55 years presented with a lower stage, lower nuclear grade, and smaller size than did the older patients. Young age was an independent prognostic factor for cancer-specific survival of low-stage clear cell RCC.
阐明年轻成人肾细胞癌（RCC）的临床病理特征及预后。已有关于年轻成人RCC特征的报道，但结果相互矛盾。
分析619例RCC患者的数据。根据诊断时的年龄将患者分为两组，即≤55岁或＞55岁。比较临床病理参数并进行生存分析。
与老年患者相比，年轻患者更可能处于较低的疾病分期（P＜0.001）、较低的核分级（P = 0.018）、较小的肿瘤大小（P = 0.005）以及更高的5年癌症特异性生存率（P＜0.001）。年轻是透明细胞RCC癌症特异性生存的有利预后因素（P＜0.001）。多因素分析显示，年轻与透明细胞RCC更长的癌症特异性生存率独立相关（P = 0.003）。此外，年龄的预后意义在低分期（I或II期）和高分期（III或IV期）肿瘤之间有所不同。在低分期透明细胞RCC中，年轻在单因素（P＜0.001）和多因素（P = 0.007）分析中均与延长的癌症特异性生存显著相关，但在高分期透明细胞RCC中则不然（P = 0.906）。
＜55岁患者的RCC与老年患者相比，分期更低、核分级更低且肿瘤更小。年轻是低分期透明细胞RCC癌症特异性生存的独立预后因素。
