Chang Jin Suk, Park Yong Hyun, Ku Ja Hyun, Kwak Cheol, Kim Hyeon Hoe
Department of Urology, Seoul National University College of Medicine, Seoul, Korea.
Korean J Urol. 2012 Jan;53(1):18-22. doi: 10.4111/kju.2012.53.1.18. Epub 2012 Jan 25.
To identify the predictors of death from other causes in patients with localized renal cell carcinoma (RCC).
We identified 1,101 patients with pathologically confirmed T1 or T2 RCC with a follow-up duration of over 6 months. Survival according to the cause of death was evaluated by using the Kaplan-Meier analysis with log-rank test. Prognostic factors for death from other causes were assessed by multivariate analysis using the Cox proportional hazard regression model. Once the prognostic factors were identified, a risk-group variable was created by counting the number of unfavorable features present for each patient.
The median follow-up was 62 months, and RCC-related death occurred in 50 patients (4.5%), whereas death from other causes occurred in 47 (4.3%). Patients who died from other causes had a higher American Society of Anesthesiologist (ASA) score (26.1% vs. 10.2%; p=0.044), older age (63.4 years vs. 55.0 years; p<0.001), smaller mass size (5.1 cm vs. 7.9 cm; p<0.001), and lower nuclear grade (p=0.003). In the multivariate Cox regression analysis, older age, higher ASA score, and lower body mass index were independent factors predicting death from other causes in patients with localized RCC. On the basis of the number of risk factors for death from other causes, the 5-year other-cause-specific survival was 98.3% (0 risk factors), 84.7% (1 risk factor), and 67.6% (2 or 3 risk factors), respectively (p<0.001).
Older age, higher ASA score, and lower body mass index were independent predictors of death from other causes in patients with localized RCC.
确定局限性肾细胞癌（RCC）患者因其他原因死亡的预测因素。
我们纳入了1101例经病理证实为T1或T2期RCC且随访时间超过6个月的患者。采用Kaplan-Meier分析和对数秩检验评估按死亡原因的生存率。使用Cox比例风险回归模型通过多变量分析评估因其他原因死亡的预后因素。一旦确定了预后因素，通过计算每位患者存在的不良特征数量创建一个风险组变量。
中位随访时间为62个月，50例患者（4.5%）发生RCC相关死亡，而47例（4.3%）因其他原因死亡。因其他原因死亡的患者美国麻醉医师协会（ASA）评分更高（26.1%对10.2%；p = 0.044）、年龄更大（63.4岁对55.0岁；p<0.001）、肿块尺寸更小（5.1 cm对7.9 cm；p<0.001）且核分级更低（p = 0.003）。在多变量Cox回归分析中，年龄较大、ASA评分较高和体重指数较低是局限性RCC患者因其他原因死亡的独立预测因素。根据因其他原因死亡的风险因素数量，5年其他原因特异性生存率分别为98.3%（0个风险因素）、84.7%（1个风险因素）和67.6%（2个或3个风险因素）（p<0.001）。
年龄较大、ASA评分较高和体重指数较低是局限性RCC患者因其他原因死亡的独立预测因素。
