Nacey J N, Delahunt B
N Z Med J. 1986 Jul 23;99(806):531-3.
A retrospective analysis was carried out on 162 patients presenting to Wellington Hospital with renal cell carcinoma between 1958 and 1978, to evaluate factors that may influence prognosis. Following radical nephrectomy the five year survival was 70% for stages 1 and 2, 53% for stage 3A and 13% for stages 3B and 3C. No patient with distant metastases survived this period. Those with renal vein or caval involvement had a significantly worse prognosis than those with stage 1 or 2 disease, and a significantly better survival than those with nodal spread. Once the tumour stage had been assigned as a baseline the influence of clinical, haematological and biochemical variables on the prognosis was analysed using a proportional hazard model. The only factor showing a significant independent association with survival was the presentation of the renal cancer as an incidental finding (p less than 0.01). The presence of anaemia or a low peripheral lymphocyte count may be independently associated with survival (p = 0.02, 0.08 respectively). Weight loss, symptoms length, the ESR, abnormality of liver function and tumour size, although associated when considered alone, do not have an independent association and therefore offer little added prognostic information. The age and sex of the patient were not related to survival.
对1958年至1978年间在惠灵顿医院就诊的162例肾细胞癌患者进行了回顾性分析，以评估可能影响预后的因素。根治性肾切除术后，1期和2期患者的五年生存率为70%，3A期为53%，3B期和3C期为13%。无远处转移的患者在此期间均未存活。肾静脉或腔静脉受累患者的预后明显差于1期或2期疾病患者，且生存率明显高于有淋巴结转移的患者。一旦将肿瘤分期作为基线，使用比例风险模型分析临床、血液学和生化变量对预后的影响。唯一与生存有显著独立关联的因素是肾癌作为偶然发现出现（p<0.01）。贫血或外周淋巴细胞计数低可能与生存独立相关（分别为p = 0.02、0.08）。体重减轻、症状持续时间、血沉、肝功能异常和肿瘤大小，虽然单独考虑时有关联，但没有独立关联，因此几乎没有提供额外的预后信息。患者的年龄和性别与生存无关。
