Five-Year Follow up in Patients after Surgery for Clear Cell Renal Carcinoma

Czech version

Authors: J. Pacovsky; J. Košina; L. Holub; P. Navrátil; P. Hušek; M. Broďák
Authors‘ workplace: Urologická klinika FN a LF UK v Hradci Králové, přednosta: as. MUDr. Miloš Broďák, Ph. D.
Published in: Rozhl. Chir., 2010, roč. 89, č. 11, s. 689-694.
Category: Monothematic special - Original

Overview

Objective:
Evaluation of the five-year follow-up of patients treated for clear-cell renal carcinoma in dependency on its characteristic and extension.

Patients’ cohort and methods:
Retrospective analysis of five-year follow-up of 269 patients treated for clear-cell renal carcinoma in dependency on T, N, M and clinical tumor stage; presence of lymphatic and distant metastases, cellular grade and tumor necrosis. Tumor-specific surviving is presented on Kaplan-Meier curves.

Results:
Five-year patients surviving with tumor T1, T2 and T3 were 91.8%, 70.7% and 34.6% respectively. Surviving patients without lymphatic metastases was 85%; with metastases was 6.9%. Surviving patients without distant metastases was 84.1%; with metastases was 0%. Surviving of patients with clinical tumor stage I, II, III and IV were 94.6%, 83.8%, 48.7% and 0% respectively. Surviving of patients with tumor cellular grade G1, G2, G3 and G4 were 87.5%, 95.5%, 64.2% and 27.6% respectively. Surviving patients without tumor necrosis was 92.4%; with metastases was 31.9%.

Conclusion:
Tumor size and the presence of metastases are very significant factors to patient survival. Histological characteristics as a nuclear grade and a tumor necrosis have been important prognostic factors for the future of the patient. Early diagnosis and aggressive surgical treatment are the most important for the positive course of the disease.

Key words:
kidney cancer – prognosis – long-term follow-up

Sources

1. www.svod.cz

2. Kawaciuk, I. Epidemiologie karcinomu ledviny. Urolog. pro Praxi, 2005; 6(6): 248–252.

3. Kawaciuk, I. Prognóza karcinomu ledviny. Praha, Galen, 2005.

4. Flanigan, R. C., Mickisch, G., Sylvester, R., et al. Cytoreductive nephrectomy in patients with metastatic renal cancer: A combined analysis. J. Urol., 2004; 171(3): 1071–1076.

5. Russo, P., Goetzl, M., Simmons, R., et al. Partial nephrectomy: The rationale expanding the indication. Ann. Surg. Oncol., 2002; 9(7): 680–687.

6. Ljunberg, B., Landberg, G., Alamdari, F. I. Factors of importance for prediction of survival in patients with metastatic renal call carcinoma, treated with or without nephrectomy. Scand. J. Urol. Nephrol., 2000; 34(4): 246–251.

7. Hora, M., Hes, O. Histologie nádorů ledvin dospělých. Ces. Urol., 1998; 2(5): 29–32.

8. European Association of Urology Guidelines 2009. Guidelines on Renal Cell Carcinoma. 1–48.

9. Pacovský, J., Broďák, M., Hušek, P., Holub, L., Košina, J., Navrátil, P., Louda, M., Podhola, M. Histologický nález nekrózy světlobuněčného karcinomu ledviny – negativní prognostický faktor. Urolog. pro Praxi, 2010; 11(1): 32–35.

10. Russo, P., Goetzl, M., Simmons, R., et al. Partial nephrectomy: The rationale expanding the indication. Ann. Surg. Oncol., 2002; 9(7): 680–687.

11. Zini, L., Capitanio, U., Jeldres, C., et al. Radical versus partial nephrectomy: effect on overal and noncancer mortality. Cancer, 2008; 115(7): 1465–1471.

12. Atzpodien, J., Schmidt, E., Gertenbach, U., Fornara, P., et al. German Kooperative Renal Carcinoma Chemo-Immunotherapy Trials Group (DGCIN): Adjutant treatment with interleukin-2 and interferon-alpha2a-based chemoimmunotherapy in renal cell Carcinoma post tumour nephrectomy: results of a prospectively randomised trial of the German Kooperative Renal Carcinoma Chemoimmunotharapy Group (DGCIN). Br. J. Cancer, 2005; 92(5): 843–846.

13. Zisman, A., Pantuck, A. J., Wieder, J., et al. Risk group assesment and clinical outcome algorithm to predict the natural of patiens with surgically resectd renal Carcinoma. J. Clin. Oncol., 2002; 20(2): 4559–4566.

14. Vít, V. Nádorové markery u renálního karcinomu: pomoc při diagnostice, prognóze, léčbě a sledování. Urol. List, 2010; 8(2): 11–15.

15. Kawaciuk, I., Dušek, P., Hyršl, L., Jarolím, L., Janík, V., Schmidt, M., Kaliská, V., Chocholatý, M., Urbanová, M. Rozměr nádoru, staging a grading malignity v prognóze karcinomu ledviny. Ces. Urol., 2005; 9(3): 36–43.

16. Kolombo, I., Poněšický, J., Podšívá, M., Pabišta, R., Porš, J., Kříž, R., Toběrný, M., Černohorský, S., Beňo, P., Kašík, J., Blažej, S., Tobiáš, J., Gronka, L., Bartůněk, M. Pokročilý karcinom ledviny – současné trendy terapie (1. část). Urolog. pro Praxi, 2009; 10(3): 182–189.

17. Kolombo, I., Poněšický, J., Podšívá, M., Pabišta, R., Porš, J., Kříž, R., Toběrný, M., Černohorský, S., Beňo, P., Kašík, J., Blažej, S., Tobiáš, J., Gronka, L., Bartůněk, M. Pokročilý karcinom ledviny – současné trendy terapie (2. část). Urolog. pro Praxi, 2009; 10(4): 218–230.

18. Flanigan, R. C., Mickisch, G., Sylvester, R., et al. Cytoreductive nephrectomy in patients with metastatic renal cancer: A combined analysis. J. Urol., 2004; 171(3): 1071–1076.

19. Escudier, B., Pluzanska, A., Koralewski, P., et al. Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma.: A randomized double-blind phase III trial. Lancet, 2007; 370(9605): 2103–2111.

20. Motzer, R. J., Hutson, T. E., Tomczak, P., et al. Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N. Engl. J. Med., 2007; 356(2): 125–134.

21. Motzer, R. J., Escudier, B., Oudart, S., et al. Efficacy of everolimus in advanced renal cell carcinoma: A double-blind, randomized, placebo-controlled phasde III trial. Lancet, 2008; 372(9637): 449–456.