Department of Andrology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, People's Republic of China.
Technol Cancer Res Treat. 2021 Jan-Dec;20:15330338211004914. doi: 10.1177/15330338211004914.
There is a lack of research on metastatic renal pelvis cell carcinoma in the current literature. In this study, we aimed to detect distant metastatic patterns in renal pelvis cell carcinoma, and illustrated the affection of different metastatic sites, surgery to primary site and chemotherapy on prognosis outcomes in patients with diverse conditions.
We collected data between 2010 and 2015 from the Surveillance, Epidemiology and End Results database. Kaplan-Meier analysis with log-rank test was used for survival comparisons. Multivariate Cox regression model was employed to analyze the effect of distant metastatic sites on overall survival (OS) and cancer-specific survival (CSS).
A total of 424 patients were included in the analysis, the median follow-up time was 5 months (interquartile range (IQR): 2-12) and 391 deaths (92.2%) in all patients were recorded. Among them, 192 (45.3%), 153 (36.1%), 137 (32.3%) and 127 (30.0%) patients were diagnosed with lung, bone, liver and brain metastases, respectively, while only 12 (2.8%) patients had brain metastases. The bi-organ, tri-organ and tetra-organ metastatic pattern was found in 135 (31.8%), 32 (7.5%) and 11 (2.6%) patients, respectively. The multivariate Cox analyses showed that distant lymph nodes (DL) metastases was not an independent prognostic factor for both OS and CSS (OS: Hazard ratios (HR) = 1.1, 95% CI = 0.8-1.4, = 0.622; CSS: HR = 1.0, 95% CI = 0.8-1.3, = 0.906). Besides, there was no significant difference of survival in patients with T3-T4 stage (OS: HR = 0.8, 95% CI = 0.5-1.2, = 0.296; CSS: HR = 0.8, 95% CI = 0.5-1.2, = 0.224), N2-3 stage (OS: HR = 0.8, 95% CI = 0.5-1.3, = 0.351; CSS: HR = 0.7, 95% CI = 0.4-1.2, = 0.259) and multi-organ metastases (OS: HR = 0.8, 95% CI = 0.5-1.3, = 0.359; CSS: HR = 0.7, 95% CI = 0.4-1.2, = 0.179) between surgery to primary site group and no-surgery to primary site group.
we described the metastatic patterns of mRPCC and the prognosis outcomes of DL metastases, surgery to primary site and chemotherapy. Our findings provide more information for clinical therapeutic intervention and translational study designs.
目前文献中缺乏对肾盂移行细胞癌转移的研究。本研究旨在检测肾盂移行细胞癌的远处转移模式，并说明不同转移部位、原发灶手术和化疗对不同情况下患者预后的影响。
我们收集了 2010 年至 2015 年期间来自监测、流行病学和最终结果数据库的数据。采用 Kaplan-Meier 分析和对数秩检验进行生存比较。采用多变量 Cox 回归模型分析远处转移部位对总生存期（OS）和癌症特异性生存期（CSS）的影响。
共纳入 424 例患者，中位随访时间为 5 个月（四分位间距（IQR）：2-12），所有患者中 391 例（92.2%）死亡。其中，192 例（45.3%）、153 例（36.1%）、137 例（32.3%）和 127 例（30.0%）患者分别诊断为肺、骨、肝和脑转移，而仅有 12 例（2.8%）患者发生脑转移。135 例（31.8%）、32 例（7.5%）和 11 例（2.6%）患者分别存在双器官、三器官和四器官转移模式。多变量 Cox 分析显示，远处淋巴结（DL）转移不是 OS 和 CSS 的独立预后因素（OS：风险比（HR）=1.1，95%CI=0.8-1.4，=0.622；CSS：HR=1.0，95%CI=0.8-1.3，=0.906）。此外，T3-T4 期（OS：HR=0.8，95%CI=0.5-1.2，=0.296；CSS：HR=0.8，95%CI=0.5-1.2，=0.224）、N2-3 期（OS：HR=0.8，95%CI=0.5-1.3，=0.351；CSS：HR=0.7，95%CI=0.4-1.2，=0.259）和多器官转移（OS：HR=0.8，95%CI=0.5-1.3，=0.359；CSS：HR=0.7，95%CI=0.4-1.2，=0.179）患者的生存在原发灶手术组和无手术组之间无显著差异。
我们描述了 mRPCC 的转移模式以及 DL 转移、原发灶手术和化疗的预后结果。我们的研究结果为临床治疗干预和转化研究设计提供了更多信息。
