Suh Jae Hee, Oak Tina, Ro Jae Y, Truong Luan D, Ayala Alberto G, Shen Steven S
Department of Pathology, Ulsan University Hospital Ulsan, Korea.
Int J Clin Exp Pathol. 2009;2(5):489-93. Epub 2009 Jan 30.
To evaluate the clinicopathologic features of renal cell carcinoma in younger adults (</=40 years), we retrospectively reviewed 838 consecutive cases of renal cell carcinoma (RCC) occurred in a single tertiary hospital. Forty-four 44 (5.2%) cases occurred in the young adult group (24 to 40 years of age). Clinicopathologic features including tumor size, stage, histologic subtype, lymph node and distant metastasis, and overall survival were compared with that of cases occurred in older age group (>40 years). The tumor size of the young adult group were smaller (5.3 vs 5.9 cm) and presented at less advanced stages (T3/T4 tumors, 18% vs 31%) than those occurring in the older age group (>40 years of age). The incidences of chromophobe RCC (12% vs. 6%) and of collecting duct carcinoma (5% vs 0.5%) were higher in the young adult group. The rate of nodal or distant metastasis was lower in young adult group (5% vs. 8.3%). More patients underwent partial nephrectomy in younger than older age group (30% vs 19%). There was no overall survival difference at 5 years (77% vs 70%), but there was a trend for a favorable survival in young adults at 10 years (77% vs 52%). In conclusion, RCC are relatively infrequent in patients who are younger than 40 years. The tumors in this group appear to be smaller and less advanced at presentation. Chromophobe RCC and collecting duct carcinoma are more frequently seen. More patients undergo partial nephrectomy and overall long term survival appears to be more favorable.
为评估年轻成人(≤40岁)肾细胞癌的临床病理特征,我们回顾性分析了一家三级医院连续收治的838例肾细胞癌(RCC)病例。44例(5.2%)发生于年轻成人组(24至40岁)。将其肿瘤大小、分期、组织学亚型、淋巴结及远处转移情况和总生存率等临床病理特征与老年组(>40岁)病例进行比较。年轻成人组肿瘤体积较小(5.3 vs 5.9 cm),且就诊时分期较低(T3/T4期肿瘤,18% vs 31%)。年轻成人组中嫌色细胞性肾细胞癌(12% vs. 6%)和集合管癌(5% vs 0.5%)的发生率较高。年轻成人组的淋巴结或远处转移率较低(5% vs. 8.3%)。与老年组相比,年轻成人组更多患者接受了肾部分切除术(30% vs 19%)。5年总生存率无差异(77% vs 70%),但10年时年轻成人有生存优势的趋势(77% vs 52%)。总之,40岁以下患者肾细胞癌相对少见。该组肿瘤就诊时似乎体积较小且分期较低。嫌色细胞性肾细胞癌和集合管癌更常见。更多患者接受肾部分切除术,总体长期生存率似乎更优。