Analysis of the Long-term Curative Effects of Radical Nephrectomy / 中国肿瘤临床

ABSTRACT

Objective:To analyze the factors that affect patient prognosis after radical nephrectomy.Meth-ods:A total of 389 cases of renal cell carcinoma treated with radical nephrectomy between January 1 993 and December 2006 were reviewed.All the data were encoded.inserted into an Excel database and then ana-lyzed by SPSS 1 3.0 software.The cumulative survival rates were calculated by life-table method.We as-sessed the impact of multiple covariates on survival time with the Cox Regression model.Results:The patho-logical results showed that 307 cases were clear call carcinoma,51 cases were papillary renal cell carcinoma,21 cases were chromophobic renal cell carcinoma,2 cases were collecting duct carcinoma.and 8 cases were unclassified.One hundred and ninety-eight cases were of T1N0M0, 113 cases were of T2N0M0, 3 cases were of T1N1M0,10 cases were of T2N1M0, 51 cases were of T3N0M0, and 14 cases were of T3N1M0, Two hundred and sixty-eight cases were followed up.The 1-year survival rate was 96.5%,the 3-year survival rate was 90.7%.the 5-year survival rate was 75.7%.and the 10-year survival rate was 65.8%.Multivariable analysis revealed that significant prognostic factors included TNM stage,Robson stage.vena cava and supplementary treat-ment(X2=22.50.P=0.001).The most important prognostic factor was pathological stage(TNM and Robson).The regression coefficients were 0.533 and 0.674,and the relative risk was 1.941 and 2.01 1(P=0.004 and p=0.002).Conclusion:Radical nephrectomy is safe and effective.TNM stage.Robson stage and vena cava are prognostic factors.Supplementary treatment is a protective factor.