Noguchi S, Shuin T, Kubota Y, Masuda M, Yao M, Kaneko S, Fukuda M, Senga Y, Nakahashi M, Kishida T
Department of Urology, Yokohama City University.
Nihon Hinyokika Gakkai Zasshi. 1995 Jul;86(7):1279-86. doi: 10.5980/jpnjurol1989.86.1279.
We examined various prognostic factors of metastatic renal cell carcinoma. Patients who had metastasis at nephrectomy (A group, 38 cases) and those who had metastasis as recurrent tumors after nephrectomy (B group, 38 cases) entered in this study. Five-year survival rate of total cases after confirmation of metastatic foci was 15% and there was no statistical significant difference between A and B groups. Several pathological factors were related to poorer prognosis and included large diameters of original tumors, positive lymph nodes, higher grade tumors and non-clear cell type tumors. Patients who have a solitary lung metastasis showed better prognosis compared to those with multiple lung metastases or metastases of other organs. Two factors related to treatment were shown to contribute to better prognosis. These were the response to interferon alfa (IFN alpha) and the possibility of total resection of visible metastatic tumors. Patients who belong to A group were shown to achieve markedly better therapeutic benefit from IFN alpha or IFN alpha plus anticancer drugs. Five-year survival rate for the responders was 40%, as compared to less than 5% for the non-responders. Ten-year survival rate for patients with metastasis who had undergone complete resection of visible tumor was 50%, and the for patients belonging to B group Showed 80%. We concluded that these prognostic factors should be considered to decide how to select patients with metastatic renal cell cancer.
我们研究了转移性肾细胞癌的各种预后因素。本研究纳入了在肾切除术时已有转移的患者（A组，38例）以及肾切除术后作为复发性肿瘤出现转移的患者（B组，38例）。在确认转移灶后，所有病例的五年生存率为15%，A组和B组之间无统计学显著差异。几个病理因素与较差的预后相关，包括原发肿瘤直径大、淋巴结阳性、肿瘤分级高以及非透明细胞型肿瘤。与有多个肺转移或其他器官转移的患者相比，有孤立性肺转移的患者预后较好。有两个与治疗相关的因素被证明对较好的预后有贡献。这两个因素是对α干扰素（IFNα）的反应以及可见转移肿瘤完全切除的可能性。结果显示，A组患者从IFNα或IFNα加抗癌药物治疗中获得的治疗益处明显更好。反应者的五年生存率为40%，而无反应者则低于5%。对可见肿瘤进行了完全切除的转移患者的十年生存率为50%，而B组患者为80%。我们得出结论，在决定如何选择转移性肾细胞癌患者时应考虑这些预后因素。
