影响肾细胞癌脊柱转移患者手术治疗后生存和预后的因素。

Factors affecting survival and prognosis in surgically treated patients with spinal metastases arising from renal cell carcinoma.

机构信息

Graduate School, Tianjin Medical University, No. 22, Qi-xiang-tai Road, He-ping District, Tianjin, 300070, China.

Department of Orthopedics, Tianjin Hospital, Tianjin University, No.406, Jie-fang South Road, Hexi District, Tianjin, 300210, China.

出版信息

BMC Urol. 2023 Jul 13;23(1):118. doi: 10.1186/s12894-023-01294-7.

DOI:10.1186/s12894-023-01294-7

PMID:37443069

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10347819/

Abstract

BACKGROUND

The objective of this study was to explore the prognostic factors for renal cell carcinoma (RCC) patients with spinal metastasis who underwent surgical treatment in our hospital.

METHODS

We retrospectively analyzed the clinical data and survival status of 49 patients with spinal metastases arising from RCC. All patients with spinal metastases underwent surgical treatment. We analyzed a range of factors that may affect the prognosis of patients with RCC. Using Kaplan-Meier method to perform univariate analysis of the factors that might affect spine metastasis free survival (SMFS)and survival after spinal metastasis (OS) respectively. Establish Cox proportional hazards model to extract independent prognostic factors for SMFS and OS.

RESULTS

The mean time of SMFS was 27 months (median 8, range 0-180 months). The mean time of OS was 12.04 months (median 9, range 2-36 months). RCC with visceral metastasis (p = 0.001,HR 11.245,95%CI 2.824-44.776) and AJCC RCC Stage (p = 0.040,HR 2.809,95%CI 1.046-7.543) can significantly affect SMFS. Furthermore, WHO/ISUP Grade (p < 0.001, HR 2.787,95%CI 1.595-4.870), ECOG Score (p = 0.019, HR 0.305,95%CI 0.113-0.825) and multiple spinal metastases (p < 0.001, HR 0.077,95%CI 0.019-0.319) have significant effects on OS.

CONCLUSIONS

RCC with visceral metastasis and AJCC RCC Stage were independent prognostic factors for SMFS. WHO/ISUP Grade, ECOG Scores and multiple spinal metastases were independent prognostic factors for OS.

摘要

背景

本研究旨在探讨我院行手术治疗的肾细胞癌（RCC）脊柱转移患者的预后因素。

方法

回顾性分析 49 例 RCC 脊柱转移患者的临床资料和生存状况。所有脊柱转移患者均行手术治疗。分析可能影响 RCC 患者预后的多种因素。采用 Kaplan-Meier 法分别对可能影响脊柱转移无进展生存（SMFS）和脊柱转移后生存（OS）的因素进行单因素分析。建立 Cox 比例风险模型提取 SMFS 和 OS 的独立预后因素。

结果

SMFS 的平均时间为 27 个月（中位数 8 个月，范围 0-180 个月）。OS 的平均时间为 12.04 个月（中位数 9 个月，范围 2-36 个月）。RCC 合并内脏转移（p=0.001，HR 11.245，95%CI 2.824-44.776）和 AJCC RCC 分期（p=0.040，HR 2.809，95%CI 1.046-7.543）可显著影响 SMFS。此外，WHO/ISUP 分级（p<0.001，HR 2.787，95%CI 1.595-4.870）、ECOG 评分（p=0.019，HR 0.305，95%CI 0.113-0.825）和多发脊柱转移（p<0.001，HR 0.077，95%CI 0.019-0.319）对 OS 有显著影响。