Department of Urology, Yamagata University, Yamagata 951-8510, Japan.
Eur Urol. 2010 Feb;57(2):317-25. doi: 10.1016/j.eururo.2008.12.026. Epub 2009 Jan 3.
Incidence rate of renal cell carcinoma (RCC) differs among countries. The rates of Asian countries are lower than those of countries in North America or Europe but are exceptionally high in Japanese males. Approximately 30% of patients with RCC have metastasis at initial diagnosis, and another 30% have metastasis after nephrectomy. Clinical studies of risk factors in patients with metastatic RCC (mRCC) are mainly based on data from non-Asian patients.
We aimed to investigate the prognosis of Japanese patients and their prognostic factors.
DESIGN, SETTING, AND PARTICIPANTS: The subjects of this study were 1463 patients who were clinically diagnosed with RCC with metastasis in 40 Japanese hospitals between January 1988 and November 2002.
The primary end point was overall survival calculated from first diagnosis of mRCC to death or last follow-up. We also investigated the relationship between survival and clinical features.
The median overall survival time was 21.4 mo. The estimated survival rates at 1, 3, 5, and 10 yr were 64.2%, 35.2%, 22.5%, and 9.1%, respectively; they contrasted with data from the United States of 54%, 19%, 10%, and 6%, respectively for the same periods. A high percentage of patients had undergone nephrectomy (80.5%) and metastasectomy (20.8%), both of which were shown to prolong survival.
The median survival time in the present study was approximately twice as long as that of previous studies from North America or Europe. Early diagnosis of metastasis, nephrectomy, metastasectomy, and cytokine-based therapy seemed to improve the prognosis of RCC patients in the present study.
肾细胞癌（RCC）的发病率在不同国家有所不同。亚洲国家的发病率低于北美或欧洲国家，但日本男性的发病率异常高。大约 30%的 RCC 患者在初始诊断时就已经转移，另有 30%的患者在肾切除术后转移。转移性 RCC（mRCC）患者的危险因素临床研究主要基于非亚洲患者的数据。
我们旨在研究日本患者的预后及其预后因素。
设计、地点和参与者：本研究的对象是 1988 年 1 月至 2002 年 11 月期间在日本 40 家医院临床诊断为 RCC 伴转移的 1463 名患者。
主要终点是从 mRCC 首次诊断到死亡或最后一次随访的总生存期。我们还研究了生存与临床特征之间的关系。
中位总生存期为 21.4 个月。估计的 1、3、5 和 10 年生存率分别为 64.2%、35.2%、22.5%和 9.1%，而同期美国的数据分别为 54%、19%、10%和 6%。有相当高比例的患者接受了肾切除术（80.5%）和转移切除术（20.8%），这两种手术都延长了生存时间。
本研究的中位生存时间约为北美或欧洲先前研究的两倍。早期诊断转移、肾切除术、转移切除术和细胞因子治疗似乎改善了本研究中 RCC 患者的预后。
