Department of Urology, Dongtan Sacred Heart Hospital, Hwaseong, Korea.
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Clin Genitourin Cancer. 2017 Oct;15(5):e819-e825. doi: 10.1016/j.clgc.2017.04.015. Epub 2017 Apr 26.
We evaluated the clinicopathologic characteristics and prognosis of Xp11.2 translocation (Xp11.2t) renal cell carcinoma (RCC) from a multicenter study and compare them with clear-cell RCC using a propensity score matching analysis.
Between 2004 and 2013, 8384 consecutive patients from 7 institutions who were diagnosed with RCC were reviewed, and the pathologically confirmed Xp11.2t cases were enrolled. The oncological outcomes of Xp11.2t were compared with those of clear-cell RCC by selecting matched cases using 1:3 propensity score matching methods in a precollected clear-cell RCC data set from our hospital. The patients were divided into 2 subgroups on the basis of age of onset, either before (early) or after (late) 45 years old.
Xp11.2t was found in 61 cases, corresponding to 0.72% of RCC cases for the 10 years. The mean age was 38.2 ± 19.4 years, and the mean tumor size was 6.2 ± 3.9 cm. The Xp11.2t cases were at more advanced stages and showed tendencies to involve lymph nodes at diagnosis. After the matching, there were no significant differences in recurrence-free and overall survival compared with clear-cell RCC. The age of incidence for Xp11.2t had a bimodal distribution, which was most common in the 30s and smaller peak in the 60s. Xp11.2t corresponded to a significantly worse prognosis for overall survival in late onset (after 45 years) subgroup (P = .038; hazard ratio, 3.199; 95% confidence interval, 1.065-9.609).
This neoplasm has more aggressive clinicopathologic features at diagnosis. In older patients with onset age > 45 years, Xp11.2t showed a significantly worse prognosis than clear-cell RCC.
我们从多中心研究中评估了 Xp11.2 易位（Xp11.2t）肾细胞癌（RCC）的临床病理特征和预后，并通过倾向评分匹配分析将其与透明细胞 RCC 进行了比较。
在 2004 年至 2013 年间，回顾了来自 7 家机构的 8384 例连续确诊的 RCC 患者，并纳入了经病理证实的 Xp11.2t 病例。通过使用我们医院预先收集的透明细胞 RCC 数据集的 1:3 倾向评分匹配方法选择匹配病例，比较 Xp11.2t 的肿瘤学结果与透明细胞 RCC 的肿瘤学结果。根据发病年龄，将患者分为 2 个亚组，即 45 岁前（早期）或 45 岁后（晚期）。
Xp11.2t 见于 61 例，占 10 年期间 RCC 病例的 0.72%。平均年龄为 38.2 ± 19.4 岁，平均肿瘤大小为 6.2 ± 3.9 cm。Xp11.2t 病例在诊断时处于更晚期，并倾向于淋巴结受累。匹配后，与透明细胞 RCC 相比，无复发生存率和总生存率无显著差异。Xp11.2t 的发病年龄呈双峰分布，最常见于 30 多岁，60 多岁时有较小的高峰。Xp11.2t 与发病年龄较大（>45 岁）亚组的总生存预后显著更差相关（P =.038；风险比，3.199；95%置信区间，1.065-9.609）。
这种肿瘤在诊断时具有更具侵袭性的临床病理特征。对于发病年龄>45 岁的老年患者，Xp11.2t 的预后明显比透明细胞 RCC 差。
