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肿瘤大小、包括泌尿系统在内的病理侵袭部位以及临床检测到的肾静脉血栓作为pT3a期局限性肾细胞癌复发预测指标的临床意义

Clinical Significance of Tumor Size, Pathological Invasion Sites Including Urinary Collecting System and Clinically Detected Renal Vein Thrombus as Predictors for Recurrence in pT3a Localized Renal Cell Carcinoma.

作者信息

Shimizu Takuto, Miyake Makito, Hori Shunta, Iida Kota, Ichikawa Kazuki, Sakamoto Keiichi, Miyamoto Tatsuki, Nakai Yasushi, Inoue Takeshi, Anai Satoshi, Tanaka Nobumichi, Fujimoto Kiyohide

机构信息

Department of Urology, Nara Medical University, 840 Shijo-cho, Kashihara, Nara 634-8522, Japan.

出版信息

Diagnostics (Basel). 2020 Mar 12;10(3):154. doi: 10.3390/diagnostics10030154.

DOI:10.3390/diagnostics10030154
PMID:32178485
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7151108/
Abstract

The recent eighth tumor-node-metastasis (TMN) staging system classifies renal cell carcinoma (RCC) with perirenal fat invasion (PFI), renal sinus fat invasion (SFI), or renal vein invasion (RVI) as stage pT3a. However, limited data are available on whether these sites have similar prognostic value or recurrence rate. We investigated the recurrence rate based on tumor size, pathological invasion sites including urinary collecting system invasion (UCSI), and clinically detected renal vein thrombus (cd-RVT) with pT3aN0M0 RCC. We retrospectively reviewed 91 patients with pT3aN0M0 RCC who underwent surgical treatment. Patients with tumor size > 7 cm, UCSI, three invasive sites (PFI + SFI + RVI), and cd-RVT showed a significant correlation with high recurrence rates (hazard ration (HR) 2.98, = 0.013; HR 8.86, < 0.0001; HR 14.28, = 0.0008; and HR 4.08, = 0.0074, respectively). In the multivariate analysis, tumor size of > 7 cm, the presence of UCSI, and cd-RVT were the independent predictors of recurrence (HR 3.39, = 0.043, HR 7.31, = 0.01, HR 5.06, = 0.018, respectively). In pT3a RCC, tumor size (7 cm cut-off), UCSI, and cd-RVT may help to provide an early diagnosis of recurrence.

摘要

最新的第八版肿瘤-淋巴结-转移（TMN）分期系统将伴有肾周脂肪浸润（PFI）、肾窦脂肪浸润（SFI）或肾静脉浸润（RVI）的肾细胞癌（RCC）归类为pT3a期。然而，关于这些部位是否具有相似的预后价值或复发率的可用数据有限。我们基于肿瘤大小、包括肾盂侵犯（UCSI）在内的病理侵犯部位以及临床检测到的肾静脉血栓（cd-RVT），对pT3aN0M0期RCC的复发率进行了研究。我们回顾性分析了91例接受手术治疗的pT3aN0M0期RCC患者。肿瘤大小>7 cm、UCSI、三个侵犯部位（PFI + SFI + RVI）以及cd-RVT与高复发率显著相关（风险比（HR）分别为2.98，P = 0.013；HR 8.86，P < 0.ooo1；HR 14.28，P = 0.0008；以及HR 4.08，P = 0.0074）。在多因素分析中，肿瘤大小>7 cm、UCSI的存在以及cd-RVT是复发的独立预测因素（HR分别为3.39，P = 0.043；HR 7.31，P = 0.01；HR 5.06，P = 0.018）。在pT3a期RCC中，肿瘤大小（以7 cm为界）、UCSI和cd-RVT可能有助于早期诊断复发。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/8a269db3da84/diagnostics-10-00154-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/4f0fc5a8bcf6/diagnostics-10-00154-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/ffa6aa667c36/diagnostics-10-00154-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/15f36e0c7319/diagnostics-10-00154-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/8a269db3da84/diagnostics-10-00154-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/4f0fc5a8bcf6/diagnostics-10-00154-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/ffa6aa667c36/diagnostics-10-00154-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/15f36e0c7319/diagnostics-10-00154-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/78f1/7151108/8a269db3da84/diagnostics-10-00154-g004.jpg

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