Hashimoto Yasunobu, Takagi Toshio, Kondo Tsunenori, Iizuka Junpei, Kobayashi Hirohito, Omae Kenji, Yoshida Kazuhiko, Tanabe Kazunari
Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan.
Int J Clin Oncol. 2015 Oct;20(5):1035-41. doi: 10.1007/s10147-015-0812-9. Epub 2015 Mar 12.
We compared the clinical features and prognosis of renal cell carcinoma (RCC) between patients on hemodialysis (RCC-HD) and those in the general population (RCC-general).
We included a total of 1,794 patients who underwent surgery (RCC-HD, 408; RCC-general, 1,386) and analyzed the clinical characteristics and oncological outcomes using a stage-for-stage analysis between the two groups.
In the RCC-HD group, the mean duration of dialysis before surgery was 120 months. Compared to the RCC-general group, the RCC-HD group tended to be younger (55 vs. 60 years, p < 0.0001) and more predominately male (84 % vs. 70 %, p < 0.0001), and the tumor size was smaller in this group (39 vs. 49 mm, p < 0.0001). The pathological characteristics of the RCC-HD group included a higher frequency of papillary tumors (22 % vs. 5 %, p < 0.0001) and stage I tumors (82 % vs. 68 %, p < 0.0001). During the follow-up period, 39 of patients (10 %) in the RCC-HD group and 193 patients (14 %) in the RCC-general group died of cancer. The patients on hemodialysis had better cancer-specific survival (CSS) than their counterparts (p = 0.0292) in the univariable analysis, but no significance was found in the multivariable analysis. In the stage-for-stage analysis, the 5-year CSS was similar between the two groups for each stage.
CSS appeared to be better in the RCC-HD group than in the RCC-general group, which may be associated with the higher incidence of stage I disease in the RCC-HD group. The comparable CSS between the groups in the stage-for-stage analysis supports this finding.
我们比较了血液透析患者肾细胞癌（RCC-HD）与普通人群肾细胞癌（RCC-general）的临床特征和预后。
我们纳入了总共1794例接受手术的患者（RCC-HD组408例；RCC-general组1386例），并通过两组间的逐期分析来分析临床特征和肿瘤学结局。
在RCC-HD组中，手术前的平均透析时间为120个月。与RCC-general组相比，RCC-HD组患者往往更年轻（55岁对60岁，p<0.0001），男性比例更高（84%对70%，p<0.0001），且该组肿瘤尺寸更小（39mm对49mm，p<0.0001）。RCC-HD组的病理特征包括乳头状肿瘤的发生率更高（22%对5%，p<0.0001）和I期肿瘤的发生率更高（82%对68%，p<0.0001）。在随访期间，RCC-HD组有39例患者（10%）死于癌症，RCC-general组有193例患者（14%）死于癌症。在单变量分析中，血液透析患者的癌症特异性生存率（CSS）优于普通人群（p = 0.0292），但在多变量分析中未发现显著差异。在逐期分析中，两组各期的5年CSS相似。
RCC-HD组的CSS似乎优于RCC-general组，这可能与RCC-HD组I期疾病的发病率较高有关。两组在逐期分析中相当的CSS支持了这一发现。
