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A Comprehensive Prognostic Stratification for Patients with Metastatic Renal Clear Cell Carcinoma

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Affiliated Author(s)
김천일
Alternative Author(s)
Kim, Chun Il
Journal Title
Yonsei Medical Journal
ISSN
0513-5796
Issued Date
2008
Abstract
Purpose: To develop a reliable prognostic model for patients
with metastatic renal cell carcinoma (RCC) based on features
readily available in common clinical settings. Patients and
Methods: A total of 197 patients with RCC who underwent
nephrectomy and immunotherapy from 1995 to 2004 were
retrospectively reviewed. Their mean age was 55.1 ± 11.8 yrs
(24 - 83 yrs) and mean survival time from metastasis was 22.6
± 20.2 mos (3 - 120 mos). The impact of 24 clinicopathological
features on disease specific survival was investigated. Results:
On univariate analysis, constitutional symptoms, sarcomatoid
differentiation, tumor necrosis, multiple primary lesions, liver
metastasis, Eastern Cooperative Oncology Group Performance
Status (ECOG-PS), thrombocytosis, alkaline phosphatase,
hematocrit, T stage, N stage, and nuclear grade had significant
influence on survival (p < 0.05). Multivariate analysis revealed
the following features associated with survival: sarcomatoid
differentiation [hazard ratio (HR) = 2.99, p < 0.001], liver
metastasis (HR = 2.09, p = 0.002), ECOG-PS (HR = 1.95, p =
0.005), N stage (HR = 1.94, p = 0.002), and number of
metastatic sites (HR = 1.76, p = 0.003). An individual prognostic
score was defined as the sum of the weight of these features.
According to prognostic scores, patients could be subdivided
into 3 groups: low risk (score 0), intermediate risk (score 1
or 2), and high risk (score ≥ 3). Conclusion: A comprehensive
prognostic stratification model was developed to predict
survival and stratify patients for prospective clinical trials.
Key Words: Carcinoma, renal cell, neoplasm metastasis,
nephrectomy, immunotherapy, prognosis
Department
Dept. of Urology (비뇨의학)
Publisher
School of Medicine
Citation
Kang Su Cho et al. (2008). A Comprehensive Prognostic Stratification for Patients with Metastatic Renal Clear Cell Carcinoma. Yonsei Medical Journal, 49(3), 451–458. doi: 10.3349/ymj.2008.49.3.451
Type
Article
ISSN
0513-5796
DOI
10.3349/ymj.2008.49.3.451
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/37245
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Urology (비뇨의학)
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