Prognostic variables to predict cancer-related death in incidental renal tumours

被引：27

作者：

Bensalah, Karim ^{[1
]}

Pantuck, Allan J. ^{[13
]}

Crepel, Maxime ^{[1
]}

Verhoest, Gregory ^{[1
]}

Mejean, Arnaud ^{[2
]}

Valeri, Antoine ^{[3
]}

Ficarra, Vincenzo ^{[14
]}

Pfister, Christian ^{[4
]}

Ferriere, Jean-Marie ^{[5
]}

Soulie, Michel ^{[6
]}

Cindolo, Luca ^{[14
]}

De la Taille, Alexandre ^{[7
]}

Tostain, Jacques ^{[8
]}

Chautard, Denis ^{[9
]}

Schips, Luigi ^{[15
]}

Zigeuner, Richard ^{[15
]}

Abbou, Claude C. ^{[7
]}

Lobel, Bernard ^{[1
]}

Salomon, Laurent ^{[7
]}

Lechevallier, Eric ^{[10
]}

Descotes, Jean-Luc ^{[11
]}

Guille, Francois ^{[1
]}

Colombel, Marc ^{[12
]}

Belldegrun, Arie S. ^{[13
]}

Patard, Jean-Jacques ^{[1
]}

机构：

[1] Rennes Univ, Dept Urol, F-35033 Rennes, France

[2] Hop Necker Enfants Malad, Paris, France

[3] Brest Univ Hosp, Brest, France

[4] Rouen Univ Hosp, Rouen, France

[5] Bordeaux Univ Hosp, Bordeaux, France

[6] Toulouse Univ Hosp, Toulouse, France

[7] Hop Henri Mondor, F-94010 Creteil, France

[8] St Etienne Hosp, St Etienne, France

[9] Angers Univ Hosp, Angers, France

[10] Marseille Univ Hosp, Marseille, France

[11] Grenoble Univ Hosp, Grenoble, France

[12] Lyon Univ Hosp, Lyon, France

[13] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA

[14] Univ Verona, I-37100 Verona, Italy

[15] Graz Univ, Graz, Austria

来源：

BJU INTERNATIONAL | 2008年 / 102卷 / 10期

关键词：

incidental tumour; renal cell carcinoma; watchful waiting; prediction;

D O I：

10.1111/j.1464-410X.2008.07847.x

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

OBJECTIVE PATIENTS AND METHODS To identify, in a large multicentre series of incidental renal tumours, the key factors that could predict cancer-related deaths, as such tumours have a better outcome than symptomatic tumours and selected patients are increasingly being included in watchful-waiting protocols. RESULTS Data from 3912 patients were extracted from three international kidney-cancer databases. Age, gender, Eastern Cooperative Oncology Group (ECOG) performance status (PS), Tumour-Node-Metastasis (TNM) stage, tumour size, Fuhrman grade, and final pathology were recorded. Benign tumours and malignant lesions with incomplete information were excluded from final analysis. The mean (SD) age of the patients was 60.6 (12.2) years and the mean tumour size 5.5 (3.5) cm. Most tumours were malignant (90.2%) and of low stage (T1-T2, 71.7%) and low grade (G1-G2, 72.4%). There were nodal and distant metastases in 5.7% and 13% of the patients. In all, 525 (14.4%) patients died from cancer; in this group, tumours were > 4 cm in 88.2% and had nodal or distant metastases in 20.2% and 49.3%, respectively. Multivariable analysis showed that tumour size > 4 cm, ECOG PS >= 1, TNM stage and Fuhrman grade were independent predictors of cancer-related death. CONCLUSION A significant proportion of incidental renal tumours can lead to the death of the patient. Standard prognostic variables for renal cell carcinoma appear to remain valid for this subset of patients. A watchful-waiting strategy should not be recommended if the tumour diameter is > 4 cm, if biopsy confirms high-grade tumours, or if there is an impaired ECOG PS, or computed tomography findings suggest the presence of advanced T stage.

引用

页码：1376 / 1380

页数：5

共 20 条

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