Department of Urology, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea.
Department of Urology, Samsung Medical Center, Seoul, Korea.
J Korean Med Sci. 2024 Jan 22;39(3):e11. doi: 10.3346/jkms.2024.39.e11.
We sought to identify prognostic risk factors for one year recurrence in patient with renal cell carcinoma (RCC) after partial or radical nephrectomy.
We performed a retrospective study of 1,269 patients with RCC after partial or radical nephrectomy and diagnosed recurrence using Korean Renal Cancer Study Group (KRoCS) database between January 1991 and March 2017. Recurrence-free survival (RFS), and overall survival (OS) were calculated using the Kaplan-Meier method and multivariate Cox regression analysis were performed to evaluate independent prognostic factors for recurrence.
The median patient age was 56 years and median follow-up period was 67 months. Multivariable analysis demonstrated BMI greater than or equal to 23 and less than 30 (vs. BMI less than 23, hazard ratio [HR]: 0.707, = 0.020) reduced recurrence one year postoperatively. Eastern Cooperative Oncology Group performance status (ECOG PS) greater than or equal to 1 (vs. ECOG PS 0, HR: 1.548, = 0.007), high pathological T stage (pT2 vs. pT1, HR: 2.622, < 0.001; pT3 vs. pT1, HR: 4.256, < 0.001; pT4 vs. pT1, HR: 4.558, < 0.001), and tumor necrosis (vs. no tumor necrosis, HR: 2.822, < 0.001) were independent predictive factors for early recurrence within one year in patients with RCC. Statistically significant differences on RFS and OS were found among pathological T stages (pT2 vs. pT1; pT3 vs. pT1; pT4 vs. pT1, all < 0.001).
This large multicenter study demonstrated ECOG PS greater than or equal to 1, high pathological T stage, tumor necrosis and BMI less than 23 were significant prognostic risk factors of early recurrence within one year in patients with RCC who underwent nephrectomy.
我们旨在确定接受肾部分或根治性切除术的肾细胞癌（RCC）患者术后一年复发的预后危险因素。
我们对 1991 年 1 月至 2017 年 3 月期间使用韩国肾癌研究组（KRoCS）数据库接受肾部分或根治性切除术的 1269 例 RCC 患者进行了回顾性研究，以诊断复发。使用 Kaplan-Meier 方法计算无复发生存期（RFS）和总生存期（OS），并进行多变量 Cox 回归分析以评估复发的独立预后因素。
患者年龄中位数为 56 岁，中位随访时间为 67 个月。多变量分析表明，BMI 大于或等于 23 且小于 30（与 BMI 小于 23 相比，HR：0.707，= 0.020）可降低术后一年的复发率。东部肿瘤协作组表现状态（ECOG PS）大于或等于 1（与 ECOG PS 0 相比，HR：1.548，= 0.007）、高病理 T 分期（pT2 与 pT1 相比，HR：2.622，< 0.001；pT3 与 pT1 相比，HR：4.256，< 0.001；pT4 与 pT1 相比，HR：4.558，< 0.001）和肿瘤坏死（与无肿瘤坏死相比，HR：2.822，< 0.001）是 RCC 患者术后一年内早期复发的独立预测因素。在病理 T 分期之间（pT2 与 pT1；pT3 与 pT1；pT4 与 pT1，均<0.001），RFS 和 OS 存在统计学显著差异。
这项大型多中心研究表明，ECOG PS 大于或等于 1、高病理 T 分期、肿瘤坏死和 BMI 小于 23 是接受肾切除术的 RCC 患者术后一年内早期复发的显著预后危险因素。
