Dabestani Saeed, Thorstenson Andreas, Lindblad Per, Harmenberg Ulrika, Ljungberg Börje, Lundstam Sven
Department of Urology, Skåne University Hospital, 205 02, Malmö, Sweden.
Section of Urology, Department of Molecular Medicine and Surgery, Karolinska Institute, 171 64, Solna, Stockholm, Sweden.
World J Urol. 2016 Aug;34(8):1081-6. doi: 10.1007/s00345-016-1773-y. Epub 2016 Feb 5.
To present the occurrence of metastases and local recurrences in primary non-metastatic patients with renal cell carcinoma (RCC) in a contemporary Swedish population-based cohort.
Between 2005 and 2009, a total of 4527 patients were included in the prospective National Swedish Kidney Cancer Register accounting for nearly all RCC patients in Sweden. Among M0 patients, 472 (13 %) had no follow-up data registered within 5-year follow-up time and were excluded from the analysis.
In total, 939 (21 %) had distant metastases at presentation with a decrease from 23 to 18 % during the inclusion period. Of 3107 patients with follow-up data and with M0 disease, 623 (20 %) were diagnosed with a tumor recurrence during 5-year follow-up. Mean time to recurrence was 24 months (SD ± 20 months). Among these, 570 patients (92 %) were at primary diagnosis treated with radical nephrectomy, 23 patients (3.7 %) with partial nephrectomy and 12 patients (1.9 %) with minimally invasive treatments. The most frequent sites of metastases were lung (54 %), lymph nodes (22 %) and bone (20 %). The treatment of recurrence was in 50 % systemic treatments, while metastasectomy was performed in 17 % of the patients, out of which 68 % were with a curative intention.
In this population-based study, 21 % of the patients had metastatic disease at presentation, with a decreasing trend over the study period. During 5-year follow-up, 20 % of the primary non-metastatic patients had recurrent disease. Of the patients with recurrence, half were given systemic oncological treatment and 17 % underwent metastasectomy.
在当代瑞典基于人群的队列中，呈现原发性非转移性肾细胞癌（RCC）患者发生转移和局部复发的情况。
2005年至2009年期间，共有4527例患者被纳入前瞻性瑞典国家肾癌登记处，该登记处涵盖了瑞典几乎所有的RCC患者。在M0患者中，472例（13%）在5年随访期内没有登记的随访数据，被排除在分析之外。
总计939例（21%）患者在初诊时已有远处转移，在纳入期间从23%降至18%。在3107例有随访数据且为M0疾病的患者中，623例（20%）在5年随访期间被诊断为肿瘤复发。复发的平均时间为24个月（标准差±20个月）。其中，570例患者（92%）在初次诊断时接受了根治性肾切除术，23例患者（3.7%）接受了部分肾切除术，12例患者（1.9%）接受了微创治疗。最常见的转移部位是肺（54%）、淋巴结（22%）和骨（20%）。复发的治疗中，50%为全身治疗，17%的患者进行了转移灶切除术，其中68%是出于治愈目的。
在这项基于人群的研究中，21%的患者在初诊时患有转移性疾病，在研究期间呈下降趋势。在5年随访期间，20%的原发性非转移性患者出现了复发性疾病。在复发患者中，一半接受了全身肿瘤治疗，17%接受了转移灶切除术。
