Zhang Zhi-Ling, Li Yong-Hong, Xiong Yong-Hong, Hou Guo-Liang, Yao Kai, Dong Pei, Liu Zhuo-Wei, Han Hui, Qin Zi-Ke, Zhou Fang-Jian
State Key Laboratory of Oncology in South China, Guangzhou, Guangdong 510060, P. R. China.
Chin J Cancer. 2010 Dec;29(12):995-9. doi: 10.5732/cjc.010.10383.
The most effective therapy against renal cell carcinoma (RCC) is surgical treatment; however, there have been few large-scale studies that focused on the oncological outcome of this disease in China. The aim of the current study was to report the clinicopathological results and cancer-specific survival (CSS) rate in RCC patients after surgical treatment in our center.
We retrospectively analyzed the clinicopathological data of 336 RCC patients who underwent radical or partial nephrectomy between 1999 and 2006. Of the 336 patients, 226 were male and 110 were female; the median age was 51 years. Univariate and multivariate analyses were conducted to identify the independent prognostic predictors for this cohort of RCC patients.
During follow-up, the overall 5-year CSS rate was 81.4%. The 5-year CSS rates for patients with stage-I, -II, -III, and -IV RCC were 94.7%, 88.9%, 68.8%, and 19.3%, respectively. The patients with T1N0M0 (T1) and T2N0M0 (T2) tumors had similar survival curves. For patients with T1 category tumor, the survival rate did not differ significantly between the radical nephrectomy and nephron-sparing surgery groups. For the 21 patients with metastasis confined to the local lymph nodes, the 5-year survival rate was 31.6% after radical nephrectomy and lymph node dissection. For the 15 patients with vena caval tumor thrombus, the 5-year survival rate was 52.5% after radical nephrectomy and tumor thrombus extirpation. Multivariate Cox regression showed that stage was an independent predictor for CSS (hazard ratio, 3.359; P < 0.001).
For localized RCC, the oncological outcome of this cohort is comparable to that reported in the Western literature. For some patients with locally advanced RCC, aggressive surgical treatment can lead to better long-term survival. However, the prognosis of the patients with metastasis still needs to be improved.
针对肾细胞癌（RCC）最有效的治疗方法是手术治疗；然而，在中国，很少有大规模研究聚焦于该疾病的肿瘤学结局。本研究的目的是报告我们中心RCC患者手术治疗后的临床病理结果及癌症特异性生存率（CSS）。
我们回顾性分析了1999年至2006年间接受根治性或部分肾切除术的336例RCC患者的临床病理资料。336例患者中，男性226例，女性110例；中位年龄为51岁。进行单因素和多因素分析以确定该队列RCC患者的独立预后预测因素。
随访期间，总体5年CSS率为81.4%。I期、II期、III期和IV期RCC患者的5年CSS率分别为94.7%、88.9%、68.8%和19.3%。T1N0M0（T1）和T2N0M0（T2）肿瘤患者的生存曲线相似。对于T1期肿瘤患者，根治性肾切除术组和保留肾单位手术组的生存率无显著差异。对于21例转移局限于局部淋巴结的患者，根治性肾切除术及淋巴结清扫术后5年生存率为31.6%。对于15例伴有腔静脉瘤栓的患者，根治性肾切除术及瘤栓摘除术后5年生存率为52.5%。多因素Cox回归分析显示，分期是CSS的独立预测因素（风险比，3.359；P<0.001）。
对于局限性RCC，该队列的肿瘤学结局与西方文献报道的相当。对于一些局部进展性RCC患者，积极的手术治疗可带来更好的长期生存。然而，转移患者的预后仍有待改善。
