Nagahara Akira, Uemura Motohide, Kawashima Atsunari, Ujike Takeshi, Fujita Kazutoshi, Miyagawa Yasushi, Nonomura Norio
Department of Urology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.
Int J Clin Oncol. 2016 Apr;21(2):367-372. doi: 10.1007/s10147-015-0879-3. Epub 2015 Jul 29.
We investigated the association between the R.E.N.A.L. nephrometry score (RNS) and the postoperative recurrence of localized renal cell carcinoma (RCC).
We retrospectively analyzed a database comprising 91 patients with non-small localized RCC (pT1b-T2b) treated by radical nephrectomy at our hospital from January 2002 to March 2010. RNS was scored based on imaging findings at diagnosis. The Cox proportional hazards model was used to predict recurrence-free survival (RFS) and to calculate hazard ratio (HR).
The median age at operation was 63 years (range, 30-85 years). Postoperative recurrence occurred in 19 patients (21 %). Median RNS sum was 9 (range, 5-11). High RNS sum (10-12) was significantly associated with RFS (P = 0.0012). Multivariate analysis revealed that high RNS sum [HR, 9.05; 95 % confidence interval (CI), 2.11-63.9; P = 0.0019] were significantly associated with RFS. Regarding each component of RNS, only the L component, which referred to tumor location relative to the polar line, was associated with RFS (HR, 15.0; 95 % CI, 2.68-396; P = 0.0006).
RNS was associated with RFS in cases of non-small localized RCC (pT1b-2b), thus supporting its utility as a prognostic factor.
我们研究了R.E.N.A.L.肾计量评分（RNS）与局限性肾细胞癌（RCC）术后复发之间的关联。
我们回顾性分析了一个数据库，该数据库包含2002年1月至2010年3月在我院接受根治性肾切除术治疗的91例非小局限性RCC（pT1b - T2b）患者。RNS根据诊断时的影像学表现进行评分。采用Cox比例风险模型预测无复发生存期（RFS）并计算风险比（HR）。
手术时的中位年龄为63岁（范围30 - 85岁）。19例患者（21%）出现术后复发。RNS总和的中位数为9（范围5 - 11）。高RNS总和（10 - 12）与RFS显著相关（P = 0.0012）。多变量分析显示，高RNS总和[HR，9.05；95%置信区间（CI），2.11 - 63.9；P = 0.0019]与RFS显著相关。关于RNS的各个组成部分，只有L部分（指肿瘤相对于极线的位置）与RFS相关（HR，15.0；95%CI，2.68 - 396；P = 0.0006）。
在非小局限性RCC（pT1b - 2b）病例中，RNS与RFS相关，因此支持其作为预后因素的效用。
