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肾原发性小细胞癌:疾病特征与治疗结果

Primary Small Cell Carcinoma of the Kidney: Disease Characteristics and Treatment Outcomes.

作者信息

Monaghan Thomas F, Michelson Kyle P, Suss Nicholas R, Agudelo Christina W, Rahman Syed N, Robins Dennis J, Flores Viktor X, McNeil Brian K, Weiss Jeffrey P, Winer Andrew G

机构信息

Department of Urology, SUNY Downstate Health Sciences University, 450 Clarkson Ave, P.O. Box 79, Brooklyn, NY 11203, USA.

Division of Urology, Kings County Hospital Center, Brooklyn, NY 11203, USA.

出版信息

Medicines (Basel). 2021 Jan 18;8(1):6. doi: 10.3390/medicines8010006.

Abstract

Primary small cell carcinoma of the kidney (PSCCK) is exceedingly rare and data on disease characteristics and outcomes are sparse. This study examines a nationally-representative cancer registry to better characterize PSCCK. We queried the National Cancer Database to identify patients with histology-confirmed PSCCK from 2004 to 2015. Adjusted Cox proportional hazards regression and Kaplan-Meier analyses were employed to assess predictors of mortality and estimate median survival time, respectively. A total of 110 patients were included (47:53% female:male, 77% ≥60 years of age, 86% Caucasian). Significant predictors of mortality included female sex, age 60-69 years, treatment at an Integrated Network Cancer Program, stage cM1, and lack of surgical and chemoradiotherapy treatment. Independent protective factors were high socioeconomic status and treatment at an Academic Research Program. The estimated median overall survival time was 9.31 (95% CI 7.28-10.98) months for all patients. No differences in estimated survival time were observed across individual treatment modalities among those patients who underwent treatment ( = 0.214). PSCCK is an aggressive malignancy with a median survival time of less than one year. Future studies that correlate clinical tumor staging with specific treatment modalities are needed to optimize and individualize management.

摘要

肾原发性小细胞癌(PSCCK)极为罕见,关于该疾病特征和预后的数据也很稀少。本研究通过一项全国代表性癌症登记系统,以更好地描述PSCCK的特征。我们查询了国家癌症数据库,以确定2004年至2015年间组织学确诊的PSCCK患者。分别采用调整后的Cox比例风险回归分析和Kaplan-Meier分析来评估死亡率的预测因素并估计中位生存时间。共纳入110例患者(女性与男性比例为47:53,77%年龄≥60岁,86%为白种人)。死亡率的显著预测因素包括女性、60 - 69岁、在综合网络癌症项目接受治疗、cM1期以及未接受手术和放化疗。独立保护因素为高社会经济地位以及在学术研究项目接受治疗。所有患者的估计中位总生存时间为9.31(95%CI 7.28 - 10.98)个月。在接受治疗的患者中,各治疗方式的估计生存时间未观察到差异(P = 0.214)。PSCCK是一种侵袭性恶性肿瘤,中位生存时间不足一年。未来需要开展将临床肿瘤分期与特定治疗方式相关联的研究,以优化和个体化治疗管理。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/70b4/7830648/16127a592c9b/medicines-08-00006-g001.jpg

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