Significant prognostic factors for 5-year survival after curative resection of renal cell carcinoma.
BACKGROUND
Renal cell carcinoma (RCC) patients occasionally die of RCC even after curative resection. In this study, we investigated prognostic factors between survivors for more than 5 years and patients who died within 5 years after curative resection.


METHODS
We retrospectively studied 111 patients who underwent RCC curative resection and were followed for more than 5 years. Patient survival at 5 years after curative resection was regarded as the end-point of this analysis. Statistical differences of 19 prognostic factors between surviving and deceased patients were determined using logistic regression analysis.


RESULTS
Eighteen of the 111 patients died of RCC during the 5-year follow-up period. Of the 19 prognostic factors evaluated, univariate analysis showed significant differences in the body temperature, hemoglobin, erythrocyte sedimentation rate (ESR), alpha2-globulin, C-reactive protein (CRP), fibrinogen, tumor size, Robson's stage, T classification (renal capsular involvement), pathological grade, and mode of tumor infiltration. Five significant variables (body temperature, ESR, alpha2-globulin, fibrinogen, and tumor size) were excluded from multivariate analysis because greater than 10% of the data was missing. The TNM staging system was selected as the representative variable for stage for multivariate analysis. Using the remaining 5 significant variables (hemoglobin, CRP, T stage, pathological grade, and mode of tumor infiltration), multivariate analysis showed that CRP (P = 0.0126) and T stage (P = 0.0490) were the most important prognostic factors.


CONCLUSIONS
From this analysis, CRP and renal capsular involvement were the most important factors predicting survival for greater than 5 years after curative resection of RCC.
Department of Urology, Hamamatsu University School of Medicine, Handa, Japan.
H
H
Masuda
Y
Y
Kurita
K
K
Fukuta
S
S
Mugiya
K
K
Suzuki
K
K
Fujita
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods*; D016017:Odds Ratio; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
D014408:Biomarkers, Tumor