OBJECTIVE: The aim of this study is to identify the pre-operative prognostic factors and create a risk stratification model for patients with renal cell carcinoma with extension into the renal vein or inferior vena cava.
METHODS: The study cohort included 61 patients with renal cell carcinoma extending into the renal vein or inferior vena cava that underwent operations between 1993 and 2012. Cancer-specific survival rates were estimated, and univariate and multivariate analyses were carried out to determine the prognostic factors. A simple risk stratification model was developed for these patients.
RESULTS: The median follow-up period of the current patient cohort was 33.7 months. Their 1, 3 and 5-year cancer-specific survival were 89, 70 and 65%, respectively. On multivariate analysis, the level of tumor thrombus extension (extension into the supradiaphragm), presence of distant metastasis and elevation of lactate dehydrogenase and C-reactive protein were independent negative prognostic factors for cancer-specific survival. Cancer-specific survival rates were clearly discriminated by the stratification according to the scoring model (P < 0.001). The concordance index of the new model was 0.80.
CONCLUSIONS: We demonstrated a simple risk stratification model with four pre-operative independent prognostic factors for patients with renal cell carcinoma with venous involvement. This may be a useful decision-making model in the management of such patients.
Written by:
Nakayama T, Saito K, Fujii Y, Abe-Suzuki S, Nakanishi Y, Kijima T, Yoshida S, Ishioka J, Matsuoka Y, Numao N, Koga F, Kihara K. Are you the author?
Department of Urology, Tokyo Medical and Dental University; Department of Human Pathology, Tokyo Medical and Dental University, Tokyo, Japan.
Reference: Jpn J Clin Oncol. 2014 Aug;44(8):756-61.
doi: 10.1093/jjco/hyu072
PubMed Abstract
PMID: 24872404
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