Histologic Subtype, Tumor Grade, Tumor Size, and Race Can Accurately Predict the Probability of Synchronous Metastases in T2 Renal Cell Carcinoma.
Kidney cancer
Metastasis
Nephrectomy
Nomogram
SEER
Stage T2
Journal
Clinical genitourinary cancer
ISSN: 1938-0682
Titre abrégé: Clin Genitourin Cancer
Pays: United States
ID NLM: 101260955
Informations de publication
Date de publication:
10 2020
10 2020
Historique:
received:
21
10
2019
revised:
08
01
2020
accepted:
02
02
2020
pubmed:
17
3
2020
medline:
19
8
2021
entrez:
17
3
2020
Statut:
ppublish
Résumé
We investigated the association between synchronous metastases (SMs), histologic subtype (HS), tumor size (TS), and tumor grade (TG) in surgically treated stage T2 renal cell carcinoma (RCC). Within the Surveillance, Epidemiology, and End Results database (2005-2015), 8344 patients with T2 RCC who had undergone radical nephrectomy were identified. The SM rates were tabulated according to the HS, TG, and TS and tested in multivariable logistic regression models. According to the HS, the average SM rates were 0%, 1.4%, 4.6%, 6.4%, 12.7%, 20.0%, and 32.7% for multilocular cystic, chromophobe, papillary, TG 1-2 clear cell, TG 3-4 clear cell, collecting duct, and sarcomatoid dedifferentiation RCC, respectively. In multivariable logistic regression models predicting for SMs, HS represented the strongest predictor, followed by TG, TS, and race. When combined, HS, TG, TS, and race predicted for SMs with 70.2% accuracy compared with 62.5% with HS, 60.2% with TG, 57.8% with TS, and 53.0% with race alone. Lung only was the most common metastatic site (43.6%), followed by bone only (27.6%), liver only (4.4%), and brain only (4.4%). Of all the patients with SMs, 78.9% had a single metastatic site. The SM rates showed very wide variation according to the HS, TG, and TS. When HS was combined with TG, TS, and race, SMs could be accurately predicted in individual patients better than with TS alone. Thus, renal mass biopsy-derived HS and TG could improve the prediction of SMs compared with using TS alone.
Sections du résumé
BACKGROUND
We investigated the association between synchronous metastases (SMs), histologic subtype (HS), tumor size (TS), and tumor grade (TG) in surgically treated stage T2 renal cell carcinoma (RCC).
MATERIALS AND METHODS
Within the Surveillance, Epidemiology, and End Results database (2005-2015), 8344 patients with T2 RCC who had undergone radical nephrectomy were identified. The SM rates were tabulated according to the HS, TG, and TS and tested in multivariable logistic regression models.
RESULTS
According to the HS, the average SM rates were 0%, 1.4%, 4.6%, 6.4%, 12.7%, 20.0%, and 32.7% for multilocular cystic, chromophobe, papillary, TG 1-2 clear cell, TG 3-4 clear cell, collecting duct, and sarcomatoid dedifferentiation RCC, respectively. In multivariable logistic regression models predicting for SMs, HS represented the strongest predictor, followed by TG, TS, and race. When combined, HS, TG, TS, and race predicted for SMs with 70.2% accuracy compared with 62.5% with HS, 60.2% with TG, 57.8% with TS, and 53.0% with race alone. Lung only was the most common metastatic site (43.6%), followed by bone only (27.6%), liver only (4.4%), and brain only (4.4%). Of all the patients with SMs, 78.9% had a single metastatic site.
CONCLUSIONS
The SM rates showed very wide variation according to the HS, TG, and TS. When HS was combined with TG, TS, and race, SMs could be accurately predicted in individual patients better than with TS alone. Thus, renal mass biopsy-derived HS and TG could improve the prediction of SMs compared with using TS alone.
Identifiants
pubmed: 32173357
pii: S1558-7673(20)30035-5
doi: 10.1016/j.clgc.2020.02.001
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e610-e618Informations de copyright
Copyright © 2020 Elsevier Inc. All rights reserved.