Department of Urology, Inje University Busan Paik Hospital, Busan 614-735, Korea.
Yonsei Med J. 2012 Sep;53(5):940-3. doi: 10.3349/ymj.2012.53.5.940.
Pathologic stage is the most accurate prognostic factor of renal cell carcinoma. We evaluated whether perirenal fat infiltration is a significant factor in tumors 7 cm or less in size.
We retrospectively reviewed the record of 164 cases of tumors 7 cm or less in size. We divided the patients into two groups according to the presence of perirenal fat infiltration (group A, pT1; group B, pT3a). We evaluated relationships, recurrence-free survival and disease-specific survival according to clinicopathologic parameters. Statistical differences were calculated by log-rank test.
A total 131 patients were included in group A, with a mean age of 55.8 years, average tumor size was 4.2 cm, and a mean follow-up period of 43 months. Group B included 33 patients, with a mean age of 55.9 years, an average tumor size of 4.1 cm, and a mean follow-up period of 38 months. There was no significant difference in disease-specific survival; however, recurrence-free survival showed significantly different between two groups (group A: 95.5%, group B: 84.4%).
In this study, perirenal fat infiltration proved to be an independent prognostic factor for predicting disease-free survival in patients with tumors of 7 cm or less in size. Therefore, as this study showed, the presence of perirenal fat infiltration requires stricter follow-up planning, even in small renal cell carcinoma.
病理分期是肾细胞癌最准确的预后因素。我们评估了肾周脂肪浸润是否是肿瘤大小为 7cm 或更小的重要因素。
我们回顾性分析了 164 例肿瘤大小为 7cm 或更小的患者记录。根据是否存在肾周脂肪浸润，我们将患者分为两组（A 组，pT1；B 组，pT3a）。我们根据临床病理参数评估了相关性、无复发生存率和疾病特异性生存率。采用对数秩检验计算统计学差异。
A 组共 131 例患者，平均年龄 55.8 岁，平均肿瘤大小为 4.2cm，平均随访时间为 43 个月。B 组包括 33 例患者，平均年龄 55.9 岁，平均肿瘤大小为 4.1cm，平均随访时间为 38 个月。疾病特异性生存率无显著差异；然而，无复发生存率两组间差异有统计学意义（A 组：95.5%，B 组：84.4%）。
在本研究中，肾周脂肪浸润被证明是预测肿瘤大小为 7cm 或更小的患者无复发生存率的独立预后因素。因此，正如本研究所示，即使是小的肾细胞癌，肾周脂肪浸润的存在也需要更严格的随访计划。
