4cm 이하의 신세포암에서 응고성 괴사의 유무 및 종양 위치가 예후에 미치는 영향
Prognostic Influence of Coagulative Tumor Necrosis and the Tumor Location for T1a Renal Cell Carcinoma
한웅규, 주정민, 이용성, 변영준, 나군호, 홍성준, 양승철,
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한웅규 ( Han Woong-Kyu )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
주정민 ( Joo Jung-Min )
연세대학교 의과대학 비뇨기과학교실, 비뇨의과학연구소
이용성 ( Lee Yong-Seong )
연세대학교 의과대학 비뇨기과학교실
변영준 ( Byun Young-Joon )
이화여자대학교 의과대학 비뇨기과학교실
나군호 ( Rha Koon-Ho )
연세대학교 의과대학 비뇨기과학교실
홍성준 ( Hong Sung-Joon )
연세대학교 의과대학 비뇨기과학교실
양승철 ( Yang Seung-Choul )
연세대학교 의과대학 비뇨기과학교실
KMID : 0358320060470050456
Abstract
Purpose: The presence of histologic coagulative necrosis in the primary tumors of patients with renal cell carcinoma has been suggested to be an important predictor of survival. This study aimed to evaluate the relationship of tumor necrosis and tumor location as compared to the other clinical features.
Materials and Methods: From June 1995 to April 2004 we retrospectively reviewed the records of 204 patients who underwent unilateral radical nephrectomy for stage T1a renal cell carcinoma. The presence of histologic coagulative necrosis in the primary tumors was recorded and the location of tumor was classified based on the computed tomography(CT) scan. Overall survival was estimated using the Kaplan-Meier method and the log-rank test, and the prognostic factors that influenced on survival were estimated using the Cox proportional hazard regression model.
Results: In this study, radical nephrectomy was performed in 148 men and 56 women with a mean age of 54.9 years(age range: 23 to 77). The mean follow-up was 31.3 months(range: 6 to 106 months). The average size of the renal cell carcinoma was 3.0cm(range: 1 to 4). The tumor locations were categorized into 2 types according to the centrality and verticality. The incidence of necrosis in T1a renal cell carcinoma was 8.7% (n=18). On the analysis of the overall survival using the log rank test, tumor necrosis(p=0.01) was a statistically significant factor.
Conclusions: For the patients with T1a renal cell carcinoma(2002 TNM stage), the presence of tumor necrosis was significantly associated with overall survival. (Korean J Urol 2006;47:456-461)
키워드
Renal cell carcinoma;Necrosis;Location
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