Shan Lisong, Shao Xue, Gu Liangyou, Wu Minhong, Lin Pengxiu, Yu Zhiling, Chen Qingsheng, Zhu Daqing
Department of Urology, Hainan Hospital, Chinese PLA General Hospital, Sanya, China.
Department of Neurology, Hainan Hospital, Chinese PLA General Hospital, Sanya, China.
Front Surg. 2022 Oct 21;9:922150. doi: 10.3389/fsurg.2022.922150. eCollection 2022.
There are still differences in the prognostic factors of renal cell carcinoma with sarcomatoid dedifferentiation (sRCC). The aim of this study was to evaluate important predictors of survival in patients with sRCC.
A comprehensive search of PubMed, Embase, and Cochrane Library was conducted to identify eligible studies. The endpoints embraced overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS). Hazard ratios (HRs) and related 95% confidence intervals (CIs) were extracted.
A total of 13 studies were included for analyses. The pooled results showed that high European Cooperative Oncology Group performance score (HR 2.39, 95% CI 1.32-4.30; = 0.004), high T stage (HR 2.18, 95% CI 1.66-2.86; < 0.001), positive lymph node (HR 1.54, 95% CI 1.40-1.69; < 0.001), distant metastasis (HR 2.52, 95% CI 1.99-3.21; < 0.001), lung metastases (HR 1.45, 95% CI 1.16-1.80; < 0.001), liver metastases (HR 1.71, 95% CI 1.30-2.25; < 0.001), tumor necrosis (HR 1.78, 95% CI 1.14-2.80; = 0.010), and percentage sarcomatoid ≥50% (HR 2.35, 95% CI 1.57-3.52; < 0.001) were associated with unfavorable OS. Positive lymph node (HR 1.57, 95% CI 1.33-1.85; < 0.001) and high neutrophil to lymphocyte ratio (HR 1.16, 95% CI 1.04-1.29; = 0.008) were associated with unfavorable CSS. High T stage (HR 1.93 95% CI 1.44-2.58; < 0.001) was associated with unfavorable progression-free survival.
A meta-analysis of available data identified important prognostic factors for CSS, OS, and PFS of sRCC, which should be systematically evaluated for patient counseling, risk stratification, and treatment selection.
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=249449.
肾细胞癌伴肉瘤样去分化（sRCC）的预后因素仍存在差异。本研究旨在评估sRCC患者生存的重要预测因素。
全面检索PubMed、Embase和Cochrane图书馆以确定符合条件的研究。终点指标包括总生存期（OS）、癌症特异性生存期（CSS）和无进展生存期（PFS）。提取风险比（HRs）及相关的95%置信区间（CIs）。
共纳入13项研究进行分析。汇总结果显示，欧洲癌症研究与治疗组织（ECOG）体能状态评分高（HR 2.39，95%CI 1.32 - 4.30；P = 0.004）、T分期高（HR 2.18，95%CI 1.66 - 2.86；P < 0.001）、淋巴结阳性（HR 1.54，95%CI 1.40 - 1.69；P < 0.001）、远处转移（HR 2.52，95%CI 1.99 - 3.21；P < 0.001）、肺转移（HR 1.45，95%CI 1.16 - 1.80；P < 0.001）、肝转移（HR 1.71，95%CI 1.30 - 2.25；P < 0.001）、肿瘤坏死（HR 1.78，95%CI 1.14 - 2.80；P = 0.010）以及肉瘤样成分百分比≥50%（HR 2.35，95%CI 1.57 - 3.52；P < 0.001）与不良OS相关。淋巴结阳性（HR 1.57，95%CI 1.33 - 1.85；P < 0.001）和高中性粒细胞与淋巴细胞比值（HR 1.16，95%CI 1.04 - 1.29；P = 0.008）与不良CSS相关。T分期高（HR 1.93，95%CI 1.44 - 2.58；P < 0.001）与不良无进展生存期相关。
对现有数据的荟萃分析确定了sRCC患者CSS、OS和PFS的重要预后因素，在患者咨询、风险分层和治疗选择时应进行系统评估。
https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=249449 。
