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与原发性肾小细胞癌患者生存相关的因素。

Factors associated with the survival of patients with primary small cell carcinoma of the kidney.

机构信息

Department of Nephrology, Chang Gung Memorial Hospital, College of Medicine, Chang Gung University, Gueishan, Taoyuan, Taiwan.

出版信息

Int J Clin Oncol. 2013 Feb;18(1):139-47. doi: 10.1007/s10147-011-0355-7. Epub 2011 Dec 6.

Abstract

BACKGROUND

Primary small cell carcinoma (SCC) of the kidney is rare, and the factors associated with the survival of these patients are yet to be elucidated.

PATIENTS AND METHODS

We collected data on patients who were admitted to our hospital for SCC of the kidney in the last 22 years and of those in studies in the literature. Clinical characteristics were summarized using descriptive statistics. The associations of these factors with survival were evaluated using Cox regression models, and the hazard ratio of death was calculated.

RESULTS

This study included 45 patients (8 admitted to our hospital and 37 from studies in the literature) with SCC of the kidney. The overall median survival time was 9.9 months (range 6.9-31.6). Data on demographics, clinical symptoms, tumor staging, and tumor characteristics recorded at the time of diagnosis were not associated with survival. Among the different treatment modalities applied, cisplatin-based chemotherapy afforded a strong survival advantage (hazard ratio = 0.35, p = 0.022). However, patients with early local recurrence (hazard ratio = 19.13, p = 0.012) and early distant metastasis (hazard ratio = 10.93, p = 0.003) after primary treatment showed significantly poor survival.

CONCLUSIONS

Patients with primary SCC of the kidney generally presented with large, advanced-stage tumors and showed poor survival. Early detection of the tumor, use of cisplatin-based chemotherapy, and careful follow-up for local recurrence or frequent metastasis within 6 months after the primary treatment could be important for improving overall patient survival.

摘要

背景

原发性肾小细胞癌(SCC)较为罕见,其患者生存相关因素尚未阐明。

方法

我们收集了过去 22 年来我院收治的肾 SCC 患者和文献研究中的患者数据。使用描述性统计方法总结临床特征。使用 Cox 回归模型评估这些因素与生存的关系,并计算死亡的风险比。

结果

本研究共纳入 45 例肾 SCC 患者(8 例来自我院,37 例来自文献研究)。总体中位生存时间为 9.9 个月(范围 6.9-31.6)。诊断时记录的人口统计学、临床症状、肿瘤分期和肿瘤特征数据与生存无关。在应用的不同治疗方式中,顺铂为基础的化疗具有明显的生存优势(风险比=0.35,p=0.022)。然而,在原发性治疗后早期局部复发(风险比=19.13,p=0.012)和早期远处转移(风险比=10.93,p=0.003)的患者生存明显较差。

结论

原发性肾 SCC 患者一般表现为较大的晚期肿瘤,生存状况较差。早期发现肿瘤、使用顺铂为基础的化疗以及在原发性治疗后 6 个月内密切随访局部复发或频繁转移可能对提高患者总体生存至关重要。

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