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1986年至2010年间手术治疗肾细胞癌的临床结果及时间趋势:瑞典单中心研究结果

Clinical outcome and time trends of surgically treated renal cell carcinoma between 1986 and 2010: results from a single centre in Sweden.

作者信息

Grabowska Beata, Ulvskog Emma, Carlsson Jessica, Fiorentino Michelangelo, Giunchi Francesca, Lindblad Per, Sundqvist Pernilla

机构信息

a Department of Urology, Faculty of Medicine and Health , Örebro University , Örebro , Sweden.

b Department of Oncology , University Hospital Örebro , Örebro , Sweden.

出版信息

Scand J Urol. 2018 Jun;52(3):206-212. doi: 10.1080/21681805.2018.1430706. Epub 2018 Jul 4.

Abstract

OBJECTIVE

The aims of this study were to create a cohort of retrospectively collected renal cell carcinoma (RCC) specimens to be used a basis for prognostic molecular studies, and to investigate the outcome and time trends in patients surgically treated for RCC in a single-centre cohort.

MATERIALS AND METHODS

Patients undergoing surgery for RCC between 1986 and 2010 were included in the study. Medical records were reviewed, and the diagnostic tissue was re-evaluated according to a modern classification. The change in patient and tumour characteristics over time was analysed.

RESULTS

The study included 345 patients. Smaller tumours, as indicated by primary tumour diameter, tumour (T) stage and American Joint Committee on Cancer (AJCC) stage, were found more frequently in later years compared to the early 1990s. No changes in the clinical outcome for the patients were seen among the time periods investigated. Increasing T stage, AJCC stage, primary tumour diameter and decreasing haemoglobin levels were associated with cancer-specific mortality in univariate analysis. A high calcium level was significantly associated with increased cancer-specific mortality (hazard ratio = 4.25, 95% confidence interval 1.36-13.28) in multivariate analysis.

CONCLUSIONS

This study on patients who underwent surgery for RCC from 1986 to 2010 at a single institution in Sweden indicates that there has been a change in tumour characteristics of patients diagnosed with RCC over time. It was also shown that calcium levels were an independent prognostic factor for cancer-specific mortality in this cohort. This cohort could provide a valuable basis for further molecular studies.

摘要

目的

本研究的目的是创建一组回顾性收集的肾细胞癌(RCC)标本,作为预后分子研究的基础,并调查在单中心队列中接受手术治疗的RCC患者的结局和时间趋势。

材料与方法

纳入1986年至2010年间接受RCC手术的患者。回顾医疗记录,并根据现代分类对诊断组织进行重新评估。分析患者和肿瘤特征随时间的变化。

结果

该研究纳入了345例患者。与20世纪90年代初相比,近年来发现的肿瘤较小,这由原发肿瘤直径、肿瘤(T)分期和美国癌症联合委员会(AJCC)分期表明。在所研究的时间段内,未观察到患者临床结局的变化。在单变量分析中,T分期增加、AJCC分期增加、原发肿瘤直径增加和血红蛋白水平降低与癌症特异性死亡率相关。在多变量分析中,高钙水平与癌症特异性死亡率增加显著相关(风险比=4.25,95%置信区间1.36-13.28)。

结论

这项对1986年至2010年在瑞典一家机构接受RCC手术的患者的研究表明,随着时间的推移,被诊断为RCC的患者的肿瘤特征发生了变化。还表明钙水平是该队列中癌症特异性死亡率的独立预后因素。该队列可为进一步的分子研究提供有价值的基础。

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