1. Prognostic analysis of postoperative clinically nonmetastatic renal cell carcinoma
- Author
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Xiang Li, Wei-Chao Dou, Hao Zeng, Wei-Xiao Yang, Qiang Wei, Guangxi Sun, Xu Hu, Shi Deng, Thongher Lia, San-Chao Xiong, and Yan-Xiang Shao
- Subjects
Male ,0301 basic medicine ,Oncology ,Cancer Research ,Kaplan-Meier Estimate ,carcinoma ,Kidney ,Nephrectomy ,0302 clinical medicine ,Renal cell carcinoma ,Epidemiology ,Stage (cooking) ,prognostic factor ,Original Research ,Cell Differentiation ,Middle Aged ,lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens ,Prognosis ,Kidney Neoplasms ,Tumor Burden ,prediction model ,Survival Rate ,030220 oncology & carcinogenesis ,Female ,Adult ,China ,medicine.medical_specialty ,lcsh:RC254-282 ,survival ,Risk Assessment ,Disease-Free Survival ,03 medical and health sciences ,Predictive Value of Tests ,Internal medicine ,medicine ,Carcinoma ,Humans ,Radiology, Nuclear Medicine and imaging ,Carcinoma, Renal Cell ,Pathological ,Survival analysis ,Aged ,Neoplasm Staging ,Retrospective Studies ,business.industry ,Proportional hazards model ,Poorly differentiated ,Clinical Cancer Research ,medicine.disease ,renal cell ,Logistic Models ,030104 developmental biology ,Feasibility Studies ,business ,Follow-Up Studies ,SEER Program - Abstract
Objectives To investigate the survival characteristics of postoperative nonmetastatic renal cell carcinoma (RCC) patients, and the predictive value of a prognostic model. Materials and Methods We retrospectively evaluated data from 1202 postoperative nonmetastatic RCC patients who were treated between 1999 and 2012 at West China Hospital, Sichuan University (Chengdu, China). In addition, we also evaluated data relating to 53 205 cases acquired from the Surveillance, Epidemiology, and End Results (SEER) program. Survival analysis was performed on the cases, and subgroups, using the Kaplan‐Meier and Cox regression methods. The concordance index of the Stage Size Grade Necrosis (SSIGN), Leibovich, and the UCLA integrated staging system, scores was determined to evaluate the accuracy of these outcome prediction models. Results The 5‐year overall survival rate for RCC cases in West China Hospital was 87.6%; this was higher than that observed for SEER cases. Survival analysis identified several factors that exerted significant influence over prognosis, including the time of surgery, Eastern Cooperative Oncology Group performance status, tumor stage, size, nuclear differentiation, pathological subtypes, along with necrotic and sarcomatoid differentiation. Moreover tumor stage, size, and nuclear grade were all identified as independent predictors for both our cases and those from the SEER program. Patient groups with advanced RCC, and poorly differentiated RCC subgroups, were both determined to have a poor prognosis. The SSIGN model yielded the best predictive value as a prognostic model, followed by the Leibovich, and UCLA integrated staging system; this was the case for our patients, and for sub‐groups with a poor prognosis. Conclusion The prognosis of RCC was mostly influenced by tumor stage, size, and nuclear differentiation. SSIGN may represent the most suitable prognostic model for the Chinese population., In our study, we aimed to investigate the survival characteristics of postoperative non‐metastatic renal cell carcinoma patients, and the predictive value of prognostic models. We retrospectively reviewed 1 202 postoperative RCC cases at the West China Hospital, Sichuan University (Chengdu, China), with 53 205 cases from the SEER database also reviewed as reference. Prognostic factors of renal cell carcinoma were analyzed in detail, and the prediction accuracy of the prognostic models was validated.
- Published
- 2019
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