Ikuerowo S O, Ojewuyi O O, Omisanjo O A, Abolarinwa A A, Bioku M J, Doherty A F
Department of Surgery, Division of Urology, Lagos State University Teaching Hospital, Ikeja, Lagos, Nigeria.
Department of Surgery, Division of Urology, LAUTECH Teaching Hospital, Osogbo, Osun State, Nigeria.
Niger J Clin Pract. 2019 Sep;22(9):1271-1275. doi: 10.4103/njcp.njcp_35_19.
Paraneoplastic syndromes (PNS) have been defined as a constellation of symptoms and signs seen in patients with malignancy, which cannot be ascribed to the local or distant spread of the tumor. Renal cell carcinoma (RCC) is most commonly associated with PNS among urological malignancies. We describe the incidence of PNS and the association between the syndromes and oncological outcomes in our patients with RCC.
A retrospective cohort study done at Lagos State University Teaching Hospital, Ikeja, Lagos. This was a retrospective review of our patients who had RCC over 11-year period (2006 to 2016). The incidence of PNS syndromes were hypercalcemia, Stauffer's syndrome, hypertension, anemia, elevated erythrocyte sedimentation rate (ESR), persistent leukocytosis, and its correlation to outcome of disease were analyzed. In addition, the age, gender, clinical features, and stage of disease were analyzed. Chi square, Fischer exact test, and Kaplan-Meier survival, curve and logistic regression.
: In total, 101 patients were operated within the period. Age of the patients ranged from 11 to 81 years (mean of 45.17 ± 16.3). There were 46 males and 55 females with M:F ratio of 1:1.2. Majority of the patients, 74 (73%), had clear cell variant of RCC. Twenty-seven patients (26.7%) had triad of flank pain, flank mass, and hematuria. The incidence of PNS were hypercalcaemia 7 (6.9%), Stauffer's syndrome 12 (11.9%), hypertension 16 (15.8%), anemia 61 (60.4%), elevated ESR 56 (55.4%), and persistent leukocytosis 3 (3.0%). At a median follow-up of 6 months, 72 patients (71.3%) were alive, whereas 29 patients (28.7%) were dead.
Among the PNS, only Stauffer's syndrome was significantly associated with poor outcome.
副肿瘤综合征（PNS）被定义为恶性肿瘤患者出现的一系列症状和体征，这些症状和体征不能归因于肿瘤的局部或远处扩散。在泌尿生殖系统恶性肿瘤中，肾细胞癌（RCC）最常与副肿瘤综合征相关。我们描述了我们的肾细胞癌患者中副肿瘤综合征的发生率以及这些综合征与肿瘤学结局之间的关联。
在拉各斯伊凯贾的拉各斯州立大学教学医院进行了一项回顾性队列研究。这是对我们在11年期间（2006年至2016年）患有肾细胞癌的患者的回顾性分析。分析了副肿瘤综合征的发生率，包括高钙血症、施陶费尔综合征、高血压、贫血、红细胞沉降率（ESR）升高、持续性白细胞增多症，以及它们与疾病结局的相关性。此外，还分析了患者的年龄、性别、临床特征和疾病分期。采用卡方检验、费舍尔精确检验、 Kaplan-Meier生存曲线和逻辑回归分析。
在此期间共有101例患者接受了手术。患者年龄在11岁至81岁之间（平均45.17±16.3岁）。男性46例，女性55例，男女比例为1:1.2。大多数患者，74例（73%）患有肾细胞癌的透明细胞变体。27例患者（26.7%）有胁腹痛、胁腹肿块和血尿三联征。副肿瘤综合征的发生率为高钙血症7例（6.9%）、施陶费尔综合征12例（11.9%）、高血压16例（15.8%）、贫血61例（60.4%）、ESR升高56例（55.4%）、持续性白细胞增多症3例（3.0%）。中位随访6个月时，72例患者（71.3%）存活，而29例患者（28.7%）死亡。
在副肿瘤综合征中，只有施陶费尔综合征与不良结局显著相关。
