The Prognostic Factors for Patients with pT1a Renal Cell Carcinoma
김종민, 송필현, 김현태, 박동춘,
소속 상세정보
김종민 ( Kim Jong-Min )
영남대학교 의과대학 비뇨기과학교실
송필현 ( Song Phil-Hyun )
영남대학교 의과대학 비뇨기과학교실
김현태 ( Kim Hyun-Tae )
영남대학교 의과대학 비뇨기과학교실
박동춘 ( Park Tong-Choon )
영남대학교 의과대학 비뇨기과학교실
KMID : 0358320100510040233
Abstract
Purpose: Although the prognosis of patients with pT1a stage renal cell carcinoma (RCC) is generally good, some of these patients show distant metastasis. In this study, we intended to identify the perioperative and pathologic prognostic factors for patients with pT1a stage RCC.
Materials and Methods: A total of 93 patients who were diagnosed with pT1aN0M0 RCC between January 1995 and December 2004 were included. All the patients underwent radical (n=63, 67.7%) or partial (n=30, 32.3%) nephrectomy by a single surgeon. Preoperative data [age, sex, body mass index (BMI), and the presence of symptoms], follow-up duration, surgical methods, and pathological parameters (tumor size, tumor location, histologic type, Fuhrman’s nuclear grade and the presence of microvascular invasion, hemorrhage, necrosis, calcification, and a cystic component in the tumor) were retrospectively analyzed to identify which of these were prognostic factors for pT1a RCC.
Results: The patients’ mean age was 55.0±11.4 years and the mean follow-up duration was 63.6±31.1 months. The 5-year cancer-specific survival rate and the 5-year recurrence-free survival rate were 100% and 88.1%, respectively. Nine patients (9.7%) showed distant metastasis, but local recurrence was not shown. Fuhrman’s nuclear grade (p=0.040, OR=5.147), microvascular invasion (p=0.011, OR=13.500), and tumor necrosis (p＜0.001, OR=26.000) had a significant impact on distant metastasis in the univariate analysis. The multivariate analysis subsequently showed that microvascular invasion (p=0.033, OR=17.947) and tumor necrosis (p=0.002, OR=15.922) were independent prognostic factors.
Conclusions: Microvascular invasion and tumor necrosis are the prognostic factors for patients with pT1a RCC.
키워드
Prognosis;Renal cell carcinoma
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