Crépel Maxime, Isbarn Hendrik, Capitanio Umberto, Liberman Daniel, Jeldres Claudio, Sun Maxine, Shariat Shahrokh F, Widmer Hugues, Arjane Philippe, Graefen Markus, Montorsi Francesco, Patard Jean-Jacques, Perrotte Paul, Karakiewicz Pierre I
Cancer Prognostics and Health Outcomes Unit, University of Montreal, Montreal, Quebec, Canada.
Urology. 2009 Oct;74(4):842-5. doi: 10.1016/j.urology.2009.02.013. Epub 2009 Jul 22.
To test whether renal cell carcinoma (RCC) histologic subtypes (HSs) affect cancer-specific mortality after nephron-sparing surgery (NSS). HSs are considered of prognostic value in RCC. For example, the papillary HS might confer a worse prognosis, and, at some centers, only radical nephrectomy is performed for the papillary HS.
We used univariate and multivariate Cox regression models to study patients with Stage T1N0M0 RCC treated with NSS (n = 1205) from 1988 to 2004. The data were taken from 9 Surveillance, Epidemiology, and End Results registries.
At 36 months after NSS, the cancer-specific mortality rate was 97.8%, 100%, and 97.4% for a clear cell, chromophobe, and papillary RCC HS, respectively. On univariate and multivariate analyses, no statistically significant differences were recorded with regard to the HS.
Despite the suggested more aggressive phenotype of the papillary HS, we found no difference among the papillary, chromophobe, and clear cell variants. Thus, the diagnosis of one HS vs another HS should not deter from the use of NSS when cancer-specific mortality is considered as an endpoint.
检验肾细胞癌（RCC）组织学亚型（HSs）是否影响保留肾单位手术（NSS）后的癌症特异性死亡率。HSs在RCC中被认为具有预后价值。例如，乳头状HS可能预后较差，在一些中心，仅对乳头状HS进行根治性肾切除术。
我们使用单变量和多变量Cox回归模型研究1988年至2004年接受NSS治疗的T1N0M0期RCC患者（n = 1205）。数据取自9个监测、流行病学和最终结果登记处。
NSS术后36个月，透明细胞、嫌色细胞和乳头状RCC HS的癌症特异性死亡率分别为97.8%、100%和97.4%。在单变量和多变量分析中，HSs方面未记录到统计学上的显著差异。
尽管提示乳头状HS具有更具侵袭性的表型，但我们发现乳头状、嫌色细胞和透明细胞变体之间没有差异。因此，当将癌症特异性死亡率作为终点时，一种HS与另一种HS的诊断不应妨碍使用NSS。
