Rodriguez-Covarrubias Francisco, Gomez-Alvarado M Olivia, Sotomayor Mariano, Castillejos-Molina Ricardo, Mendez-Probst Carlos E, Gabilondo Fernando, Feria-Bernal Guillermo
Department of Urology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
Urol Int. 2011;86(1):47-52. doi: 10.1159/000319368. Epub 2010 Sep 1.
To evaluate the prognostic impact of early recurrence (within 12 months) after surgery on cancer-specific survival (CSS) of patients with localized clear-cell renal cell carcinoma (ccRCC).
Patients with surgically treated localized ccRCC were studied. Using the Kaplan-Meier method, we calculated CSS; by univariate and multivariate models we analyzed the association of early recurrence with cancer-related mortality.
We identified 259 patients with pT1-4/NX/0M0 ccRCC treated between February 1981 and September 2009; of 66 (25.5%) with disease recurrence, 29 (43.9%) had early relapse. Overall, 43 patients (16.6%) died from ccRCC. The 5- and 10-year CSS for those without, late and early recurrence was 98.5 and 96.5%, 53 and 39.8%, and 23 and 23%, respectively (p < 0.0001). In the multivariate Cox model, pT stage (p = 0.01) and early recurrence (p < 0.0001) independently predicted CSS.
Recurrent disease after localized ccRCC confers a poor prognosis, especially if detected within 12 months after surgery. Thus, this criterion should be included as an independent risk factor for cancer-related mortality.
评估手术治疗后早期复发（12个月内）对局限性透明细胞肾细胞癌（ccRCC）患者癌症特异性生存（CSS）的预后影响。
对接受手术治疗的局限性ccRCC患者进行研究。采用Kaplan-Meier方法计算CSS；通过单因素和多因素模型分析早期复发与癌症相关死亡率的关联。
我们纳入了1981年2月至2009年9月期间接受治疗的259例pT1-4/NX/0M0 ccRCC患者；在66例（25.5%）疾病复发患者中，29例（43.9%）为早期复发。总体而言，43例（16.6%）患者死于ccRCC。无复发、晚期复发和早期复发患者的5年和10年CSS分别为98.5%和96.5%、53%和39.8%、23%和23%（p<0.0001）。在多因素Cox模型中，pT分期（p = 0.01）和早期复发（p < 0.0001）可独立预测CSS。
局限性ccRCC复发后的疾病预后较差，尤其是在术后12个月内检测到复发。因此，该标准应作为癌症相关死亡率的独立危险因素纳入考量。
