Department of Urology, Center for Prostate Cancer, Research Institute and Hospital of National Cancer Center, Goyang, Korea.
Biomolecular Function Research Branch, Research Institute, National Cancer Center, Goyang, Gyeonggi-do, Korea.
Sci Rep. 2018 Feb 14;8(1):2974. doi: 10.1038/s41598-018-20822-2.
We compared progression-free survival (PFS) and overall survival (OS) among 292 metastatic renal cell carcinoma (mRCC) patients either undergoing nephrectomy (Nx, 61.6%) or not (non-Nx, 38.4%), stratified according to the MSKCC and Heng risk models, treated with either immunotherapy (IT, 45.2%) or targeted therapy (TT, 54.8%) between 2000 and 2015. During the follow-up duration of 16.6 months, PFS/OS of the Nx (6.0/30 months) and non-Nx (3.0/6.0 months) groups were significantly different despite differences among baseline parameters (p < 0.05). The intermediate- and poor-risk patients defined using either model showed significantly longer PFS and OS in the Nx group than in the non-Nx group (p < 0.05). After stratifying groups by systemic therapy and risk models, both the Nx and non-Nx groups showed no significant differences in intermediate and poor-risk models (p > 0.05). In both synchronous and metachronous mRCC patients, both PFS and OS showed similar survivals; the Nx group had significantly longer PFS and OS than the non-Nx group, even after considering each systemic therapy and prognostic model. Nx showed a significant positive benefit in PFS and OS compared to no Nx upon patient stratification according to the MSKCC and Heng risk models. The metastatic type did not significantly affect survival between the two groups.
我们比较了 292 例转移性肾细胞癌（mRCC）患者的无进展生存期（PFS）和总生存期（OS），这些患者根据 MSKCC 和 Heng 风险模型分为接受肾切除术（Nx，61.6%）和未接受肾切除术（非 Nx，38.4%）两组，这些患者在 2000 年至 2015 年间接受免疫治疗（IT，45.2%）或靶向治疗（TT，54.8%）。在 16.6 个月的随访期间，尽管基线参数存在差异（p<0.05），但 Nx（6.0/30 个月）和非 Nx（3.0/6.0 个月）组的 PFS/OS 差异仍具有统计学意义。使用两种模型定义的中危和高危患者，Nx 组的 PFS 和 OS 明显长于非 Nx 组（p<0.05）。按系统治疗和风险模型分层后，无论是 Nx 组还是非 Nx 组，中危和高危模型之间均无显著差异（p>0.05）。在同步和异时性 mRCC 患者中，PFS 和 OS 的生存情况相似；即使考虑了每种系统治疗和预后模型，Nx 组的 PFS 和 OS 也明显长于非 Nx 组。根据 MSKCC 和 Heng 风险模型对患者进行分层，与非 Nx 相比，Nx 在 PFS 和 OS 方面具有显著的积极获益。转移类型在两组之间的生存影响无显著差异。
