[Survival analysis in renal cell carcinoma with invasion of the vena cava].
Ninety-nine consecutive patients with renal cell carcinoma in stages pT1-4/N0-3/V0-2/M0 were analyzed. Overall 5 year survival was 61%. Factors with greater impact on survival were: 1) degree of anaplasia (DI 73%, DII 47%, DIII 27%; p = 0.0005), 2) pathological stage (pT1-2 87%, pT3 39%; p = 0.0000), 3) perirenal fat invasion (pT1-2 87%, pT3a 60%; p = 0.007), 4) node status (N0 72%, N1-3 17%; p = 0.0000) and 5) veins invasion (V0 74%, V1-2 35%; p = 0.005). No difference in survival between V1 and V2 (40% vs 33%; p0.05) tumours was found. A multivariable study showed that the degree of anaplasia and veins invasion have a significant and separate influence on survival (p = 0.0000). Among patients with vascular invasion, those with no perirenal fat invasion or node damage show better survival rates than patients with capsular infiltration (62% vs 40%; p) and perform significantly better than patients with capsular invasion and nodal implication (62% vs 30%; p). No survival differences were observed between pT3b stages with venous invasion only and pT1-2 stages (p0.05). Venous invasion is not in itself of prognostic relevance; the prognostic significance of vascular invasion is directly related to the presence of perirenal fat invasion and/or nodal implication.
Departamento de Urología, Clínica Universitaria, Universidad de Navarra, Pamplona.
P
P
Sánchez de la Muela
J J
JJ
Zudaire
J E
JE
Robles
D
D
Rosell
L
L
Aguera
F
F
De Castro
W
W
Isa
J M
JM
Berián
D000328:Adult; D000368:Aged; D002292:Carcinoma, Renal Cell / Q000401:mortality* / Q000473:pathology; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D016019:Survival Analysis; D014684:Venae Cavae
Análisis de la supervivencia en el carcioma de células renales con invasión de la vena cava.