Oncological and functional outcomes after radical nephrectomy for renal cell carcinoma: A comprehensive analysis of prognostic factors. (25th September 2012)

• Record Type: Journal Article
• Authors: Sejima, Takehiro; Iwamoto, Hideto; Masago, Toshihiko; Morizane, Shuichi; Hinata, Nobuyuki; Yao, Akihisa; Isoyama, Tadahiro; Saito, Motoaki; Takenaka, Atsushi
• Is Part Of: International journal of urology. Volume 20:Number 4(2013)
• Page Start: 382
• Page End: 389
• Publication Date: 2012-09-25
• Subjects: Urology -- Periodicals; Genitourinary organs -- Periodicals; Urologic Diseases -- Periodicals; 616.6005
• DOI: 10.1111/j.1442-2042.2012.03176.x
• Languages: English
• ISSNs: 0919-8172

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="iju3176-sec-0001" sec-type="section"> <title>Objectives</title> <p>To investigate mortality rates and to comprehensively analyze prognostic indicators after radical nephrectomy for renal cell carcinoma.</p> </sec> <sec id="iju3176-sec-0002" sec-type="section"> <title>Methods</title> <p>Data were collected from 147 patients who underwent potentially curative radical nephrectomy for renal cell carcinoma. The following data were analyzed: tumor pathology, patient demographics and clinical parameters, such as pre‐ and postoperative estimated glomerular filtration rate, as well as the cause of death. Cause‐specific survival rates were calculated including deaths caused by renal cell carcinoma and cardiovascular disease. A Cox proportional hazard model was used for statistical analysis.</p> </sec> <sec id="iju3176-sec-0003" sec-type="section"> <title>Results</title> <p>A univariate analysis showed that age at surgery (≥70 years), postoperative estimated glomerular filtration rate (<45 mL/min/1.73 m<sup>2</sup>), pathological high T stage, grade and venous invasion were significant poor prognostic indicators. The multivariate analysis provided evidence that pathological venous invasion was a significant poor prognostic indicator, whereas age at surgery (≥70 years), pre‐ (<65 mL/min/1.73 m<sup>2</sup>) or postoperative (<45 mL/min/1.73 m<sup>2</sup>) estimated glomerular filtration rate and pathological high grade were significant poor prognostic indicators in T1 tumor cases.</p> </sec> <sec id="iju3176-sec-0004" sec-type="section"> <title>Conclusions</title> <p>Post‐radical nephrectomy renal function insufficiency can lead to a poor prognostic outcome, especially in patients with T1 renal cell carcinoma. Physicians should consider a comprehensive follow up focusing on possible causes of death, including those related to both renal cell carcinoma and cardiovascular disease events after radical nephrectomy.</p> </sec> </abstract>