Kim Jeong Ho, Seo Seong Il, Song Cheryn, Chung Jinsoo, Kwak Cheol, Hong Sung-Hoo
Department of Urology, Dongnam Institute of Radiological & Medical Sciences Cancer center, Busan, Korea;
Department of Urology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea;
Can Urol Assoc J. 2015 Sep-Oct;9(9-10):E705-8. doi: 10.5489/cuaj.2855. Epub 2015 Oct 13.
In this retrospective multicentre study, we compared the clinicohistological characteristics of renal cell carcinoma (RCC) between pediatric and adult patients.
Data for patients who underwent radical or partial nephrectomy for RCC between 1988 and 2014 at multiple institutions were collected. Patients were divided into 2 groups according to age at diagnosis: pediatric patients (age ≤18 years) and adult patients (age ≥40 years). The groups were compared for clinical and pathologic variables, and survival analysis was performed.
The median follow-up period was 64 (range: 30-91) months for pediatric patients versus 44 (range: 19-59) months for adult patients (p = 0.026). Pediatric patients were mostly female (p = 0.003), had symptoms at presentation (p < 0.001), and had a high-stage tumour (p = 0.014) than adult patients. Among the symptomatic patients, gross hematuria was the most common symptom. The median tumour size was not different between groups. Regarding histologic types, pediatric patients had more papillary tumours (p < 0.001), more unclassified tumours (p < 0.001), and fewer clear cell carcinomas (p < 0.001). Five-year cancer-specific survival rates were 85% and 87.4% in pediatric and adult patients, respectively (log rank p = 0.901). Recurrence-free survival was better in adult patients, although this did not reach statistical significance (log rank p = 0.272). This study has several limitations, including its retrospective nature and the relatively small number of pediatric RCC cases.
RCC in children is rare and is characterized by features that differ from those in adult RCC. Prognosis did not differ between groups.
在这项回顾性多中心研究中,我们比较了儿童和成人肾细胞癌(RCC)的临床组织学特征。
收集了1988年至2014年间在多个机构因RCC接受根治性或部分肾切除术患者的数据。根据诊断时的年龄将患者分为两组:儿童患者(年龄≤18岁)和成人患者(年龄≥40岁)。比较两组的临床和病理变量,并进行生存分析。
儿童患者的中位随访期为64(范围:30 - 91)个月,而成人患者为44(范围:19 - 59)个月(p = 0.026)。儿童患者大多为女性(p = 0.003),就诊时出现症状(p < 0.001),且肿瘤分期高于成人患者(p = 0.014)。在有症状的患者中,肉眼血尿是最常见的症状。两组间肿瘤大小中位数无差异。关于组织学类型,儿童患者有更多的乳头状肿瘤(p < 0.001)、更多未分类肿瘤(p < 0.001)以及更少的透明细胞癌(p < 0.001)。儿童和成人患者的5年癌症特异性生存率分别为85%和87.4%(对数秩检验p = 0.901)。成人患者的无复发生存率更好,尽管未达到统计学显著性(对数秩检验p = 0.272)。本研究有几个局限性,包括其回顾性性质以及儿童RCC病例数量相对较少。
儿童RCC罕见,其特征与成人RCC不同。两组的预后无差异。