Zhi Yunlai, Li Xiao, Qi Feng, Hu Xin, Xu Wenbo
Department of Urology, Lianyungang Clinical College of Nanjing Medical University & The First People's Hospital of Lianyungang, Lianyungang 222002, China.
Department of Urologic Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & Affiliated Cancer Hospital of Nanjing Medical University, Nanjing 210009, China.
J Oncol. 2020 Oct 31;2020:8887782. doi: 10.1155/2020/8887782. eCollection 2020.
The purpose of this article was to explore the association of tumor size with lymph node metastases (LNM) risk in patients with clear cell renal cell carcinoma (ccRCC). Based on the Surveillance, Epidemiology, and End Result (SEER) database, patients diagnosed with ccRCC from 1988 to 2015 were included in this study. For each patient, personal characteristics, clinicopathological data, and survival outcomes were, respectively, collected. Subsequently, the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to investigate the potential risk factors for LNM in ccRCC. Finally, Kaplan-Meier (KM) survival plots of overall survival (OS) and ccRCC-specific survival (CSS) were evaluated on the basis of different tumor sizes. A total of 8,292 patients were finally enrolled in the study, 1,170 of whom (14.11%) had LNM. According to the heatmap, we could intuitively interpret that larger tumor size was related to an increased risk of LNM obviously. The risk of LNM was evidently greater for larger tumor size (4-7 cm: OR = 2.415, 95% CI = 1.708-3.415; 7-10 cm: OR = 3.746, 95% CI = 2.677-5.242; and >10 cm: OR = 4.617, 95% CI = 3.302-6.457) compared with smaller tumor size (≤4 cm). According to the KM survival plots of OS and CSS, we observed a gradual decline in survival with increasing tumor size, while the smallest tumor size had the best survival outcomes. These results indicated the positive relationship of tumor size with risk of LNM in ccRCC. And we also noticed continual decrease survival rates of OS and CSS with increasing tumor size.
本文旨在探讨透明细胞肾细胞癌（ccRCC）患者肿瘤大小与淋巴结转移（LNM）风险之间的关联。基于监测、流行病学和最终结果（SEER）数据库，本研究纳入了1988年至2015年诊断为ccRCC的患者。对于每位患者，分别收集其个人特征、临床病理数据和生存结局。随后，计算优势比（OR）和95%置信区间（CI），以研究ccRCC中LNM的潜在危险因素。最后，根据不同的肿瘤大小评估总生存（OS）和ccRCC特异性生存（CSS）的Kaplan-Meier（KM）生存曲线。本研究最终共纳入8292例患者，其中1170例（14.11%）发生LNM。根据热图，我们可以直观地看出，肿瘤越大，LNM风险明显增加。与较小肿瘤大小（≤4 cm）相比，较大肿瘤大小（4-7 cm：OR = 2.415，95% CI = 1.708-3.415；7-10 cm：OR = 3.746，95% CI = 2.677-5.242；>10 cm：OR = 4.617，95% CI = 3.302-6.457）的LNM风险明显更高。根据OS和CSS的KM生存曲线，我们观察到随着肿瘤大小增加，生存率逐渐下降，而最小肿瘤大小的生存结局最佳。这些结果表明ccRCC中肿瘤大小与LNM风险呈正相关。并且我们还注意到随着肿瘤大小增加，OS和CSS的生存率持续下降。
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