Correlation Among Clinical and Pathological Parameters and Disease-Free Survival of Patients with Renal Cancer Treated with Surgery at a Public Cancer Clinic in Curitiba
DOI:
https://doi.org/10.32635/2176-9745.RBC.2022v68n4.2679Keywords:
kidney neoplasms, survival analysis, nephrectomyAbstract
Introduction: Kidney cancer corresponds to the 13th most incident cancer in the world, and the third most common type of genitourinary cancer. Most patients are asymptomatic, and the diagnosis used to be incidental during routine imaging exams. Surgical treatment is the gold standard. Objective: To correlate clinical and pathological parameters with disease-free survival in renal cancer patients submitted to nephrectomy. Method: Retrospective study with 99 patients who underwent surgical treatment of kidney cancer from 2010 to 2020. Clinical and pathological parameters were compared with the clinical oncologic outcome after surgery. Results: Ninety-nine patients were followed-up postoperatively for an average time of 26.9 months, and the mean disease-free survival was 61.9%. Univariate analysis showed that tumor size >7 cm and Fuhrman grades III and IV were risk factors related to disease progression after nephrectomy (p=0.046 and CI=1.017-7.083; p=0.005 and CI=1.725-23.004, respectively). In the multivariate analysis, tumor size > 7cm (p=0.014 and CI=1.290-9.326) and Fuhrman grades III and IV (p=0.028 and CI=1.174-16.616) were identified as predictors of progression. Conclusion: Tumor size >7 cm and/or Fuhrman grades III or IV are risk factors for tumor recurrence after surgical treatment of renal cancer.
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References
Capitanio U, Bensalah K, Bex A, et al. Epidemiology of renal cell carcinoma. Eur Urol. 2019;75(1):74-84. doi: https://doi.org/10.1016/j.eururo.2018.08.036
Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2009. CA Cancer J Clin. 2009;59(4):225-49. doi: https://doi.org/10.3322/caac.20006
Jemal A, Siegel R, Ward E, et al. Cancer statistics, 2006. CA Cancer J Clin. 2006;56(2):106-30. doi: https://doi.org/10.3322/canjclin.56.2.106
Atkins MB. Clinical manifestations, evaluation, and staging of renal cell carcinoma [Internet]. UpToDate. [date unknown] [updated 2022 Jan 21; cited 2022 Apr 19]. Available from: https://www.uptodate.com/contents/clinical-manifestations-evaluation-and-staging-of-renal-cell-carcinoma?sectionName
Brierley JD, Gospodarowicz MK, Wittekind C, editors. TNM classification of malignant tumors [Internet]. 8th ed. Genève (FR): Union for International Cancer Control; 2009.
Klatte T, Ficarra V, Gratzke C, et al. A literature review of renal surgical anatomy and surgical strategies for partial nephrectomy. Eur Urol. 2015;68(6):980-92. doi: https://doi.org/10.1016/j.eururo.2015.04.010
Zisman A, Pantuck AJ, Chao D, et al. Reevaluation of the 1997 TNM classification for renal cell carcinoma: T1 and T2 cutoff point at 4.5 rather than 7 cm. better correlates with clinical outcome. J Urol. 2001;166(1):54-8. doi: https://doi.org/10.1016/S0022-5347(05)66075-2
MacLennan S, Imamura M, Lapitan MC, et al. Systematic review of perioperative and quality-of-life outcomes following surgical management of localised renal cancer. Eur Urol, 2012;62(6):1097-117. doi: https://doi.org/10.1016/j.eururo.2012.07.028
Patard JJ, Pantuck AJ, Crepel M, et al. Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication. Eur Urol. 2007;52(1):148-54. doi: https://doi.org/10.1016/j.eururo.2007.01.039
Atkins MB, Bakouny Z, Choueiri TK. Epidemiology, pathology, and pathogenesis of renal cell carcinoma [Internet]. UpToDate. [date unknown] [updated 2022 Sept 20; cited 2020 Apr 19]. Available from: https://www.uptodate.com/contents/epidemiology-pathology-and-pathogenesis-of-renal-cell-carcinoma
Dall’Oglio MF, Crippa A, Camara C, et al. The beginning of the 21st century: A paradigm shift in the surgical management of renal cell carcinoma in South America. Int Braz J Urol. 2010;36(6):670-7. doi: https://doi.org/10.1590/S1677-55382010000600004
Ferreira JC, Patino CM. What is survival analysis, and when should I use it? J Bras Pneumol. 2016;42(1):77-77. doi: https://doi.org/10.1590/S1806-37562016000000013
Kontak JA, Campbell SC. Prognostic factors in renal cell carcinoma. Urol Clin North Am. 2003;30(3):467-80. doi: https://doi.org/10.1016/S0094-0143(03)00020-X
Patard JJ, Dorey FJ, Cindolo L, et al. Symptoms as well as tumor size provide prognostic information on patients with localized renal tumors. J Urol. 2004;172(6 Pt 1):2167-71. doi: https://doi.org/10.1097/01.ju.0000141137.61330.4d
Dall’Oglio MF, Ribeiro-Filho LA, Antunes AA, et al. Microvascular Tumor Invasion, Tumor Size and Fuhrman Grade: A Pathological Triad for Prognostic Evaluation of Renal Cell Carcinoma. J Urol. 2007;178(2):425-8. doi: https://doi.org/10.1016/j.juro.2007.03.128
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