Prognostic factors of patients with T3 N0 M0 renal cell carcinoma:a single-center retrospective study of 182 patients / 北京大学学报(医学版)

ABSTRACT

Objective:To evaluate the impacts of clinical,pathological,and laboratory factors on on-cological outcomes of patients with T3 N0 M0 renal cell carcinoma.Methods:The clinical data,laboratory exam results,and follow-up outcomes of 182 patients with T3 N0 M0 renal cell carcinoma who underwent nephrectomy from 2007 to 2012 in Peking University First Hospital were retrospectively collected.The 5-year cancer-specific survival and 5-year recurrence-free survival of all the patients were calculated using Kaplan-Meier method,and the statistical significance between the survival curves were compared using the Log-rank test.Variables with significant differences in the univariate analysis were subjected to the multivariate analysis by Cox regression model.All the comparisons were conducted using two-tailed test and P <0.05 was considered statistically significant.Results:A total of 182 patients were included in this study.Of all the 182 patients,126 were male (69.23%)and 56 were female (30.77%).The mean age was (56.75 ±12.45)years.The median follow-up time was 48 months (3 -99 months).At the end of the follow-up,50 patients (27.47%)died due to the disease after a median of 29.74 months and 59 patients (32.42%)had tumor recurrence after a median of 22.12 months.The 5-year cancer-specific survival of all patients was 68.30% (95% CI:60.16% -75.84%);the 5-year recurrence-free survival was 60.70% (95% CI:53.16% -68.84%).In the univariate analysis,diabetes mellitus, tumor invasion status,Fuhrman grade,serum album,serum cholestenone,anemia,and neutrophils per-centage were associated with the cancer-specific survival and Fuhrman grade,serum album and anemia were associated with the recurrence-free survival.Variables with significant differences on univariate analysis were included in Cox multivariate regression analysis.Multivariate Logistic regression analysis showed that diabetes mellitus (HR =2.434,95% CI:1.243 -4.769,P =0.010),hypoalbuminemia (HR =2.188,95% CI:1.074 -1.074,P =0.031),and anemia (HR =3.320,95% CI:1.839 -5.991,P <0.001)were independent risk factors significantly associated with cancer-specific survival;and higher Fuhrman grade (HR =2.552,95% CI:1.433 -4.545,P =0.001),anemia (HR =2.535, 95% CI:1.497 -4.293,P =0.001)were independent factors significantly associated with recurrence-free survival.Conclusion:Diabetes mellitus,hypoalbuminemia,and anemia were independent risk fac-tors significantly associated with cancer-specific survival of T3 N0 M0 renal cell carcinoma patients;higher Fuhrman grade and anemia were independent risk factors significantly associated with tumor recurrence of T3 N0 M0 renal cell carcinoma patients.