Wang Jue, Wang Fen Wei, Kessinger Anne
Division of Oncology/Hematology, Department of Internal Medicine, University of Nebraska Medical Center, Omaha, NE 68198-7680, USA.
Adv Urol. 2011;2011:693964. doi: 10.1155/2011/693964. Epub 2011 Jul 20.
Background. The objective of this paper was to examine the epidemiology, natural history, and prognostic factors of carcinosarcoma of the kidney and renal pelvis (CSKP) using population-based registry. Patients and Methods. Forty-three patients with CSKP, diagnosed between January 1973 and December 2007, were identified from the national Surveillance, Epidemiology, and End Results (SEER) database and reviewed. Results. 79% of all patients with known SEER stage were classified as having regional or distant stage; almost all the patients with known histology grade had poorly or undifferentiated histology. The median cancer specific survival was 6 months (95% CI 4-9). The 1-year cancer-specific survival rate for entire cohort was 30.2%. There were no differences in terms of age at diagnosis, histological grade, tumor stage on presentation, and frequency of nephrectomy between carcinosarcoma of kidney (CSK) or renal pelvis (CSP). In multivariate analysis, age at diagnosis, tumor stage, and year of diagnosis were found to be significant predictors for cancer-specific survival. Conclusion. CSKP commonly presented as high-grade, advanced stage disease, and was associated with a poor prognosis regardless of location.
背景。本文的目的是利用基于人群的登记系统研究肾和肾盂癌肉瘤(CSKP)的流行病学、自然史和预后因素。患者与方法。从国家监测、流行病学和最终结果(SEER)数据库中识别出1973年1月至2007年12月期间诊断的43例CSKP患者并进行回顾。结果。所有已知SEER分期的患者中,79%被归类为区域或远处分期;几乎所有已知组织学分级的患者组织学分级均为低分化或未分化。癌症特异性生存中位数为6个月(95%CI 4 - 9)。整个队列的1年癌症特异性生存率为30.2%。肾(CSK)或肾盂(CSP)癌肉瘤在诊断年龄、组织学分级、初诊时肿瘤分期及肾切除术频率方面无差异。多因素分析显示,诊断年龄、肿瘤分期和诊断年份是癌症特异性生存的显著预测因素。结论。CSKP通常表现为高级别、晚期疾病,无论其位置如何,预后均较差。