Prognosis of Japanese metastatic renal cell carcinoma patients in the cytokine era: a cooperative group report of 1463 patients.
BACKGROUND
Incidence rate of renal cell carcinoma (RCC) differs among countries. The rates of Asian countries are lower than those of countries in North America or Europe but are exceptionally high in Japanese males. Approximately 30% of patients with RCC have metastasis at initial diagnosis, and another 30% have metastasis after nephrectomy. Clinical studies of risk factors in patients with metastatic RCC (mRCC) are mainly based on data from non-Asian patients.


OBJECTIVE
We aimed to investigate the prognosis of Japanese patients and their prognostic factors.


METHODS
The subjects of this study were 1463 patients who were clinically diagnosed with RCC with metastasis in 40 Japanese hospitals between January 1988 and November 2002.


METHODS
The primary end point was overall survival calculated from first diagnosis of mRCC to death or last follow-up. We also investigated the relationship between survival and clinical features.


CONCLUSIONS
The median overall survival time was 21.4 mo. The estimated survival rates at 1, 3, 5, and 10 yr were 64.2%, 35.2%, 22.5%, and 9.1%, respectively; they contrasted with data from the United States of 54%, 19%, 10%, and 6%, respectively for the same periods. A high percentage of patients had undergone nephrectomy (80.5%) and metastasectomy (20.8%), both of which were shown to prolong survival.


CONCLUSIONS
The median survival time in the present study was approximately twice as long as that of previous studies from North America or Europe. Early diagnosis of metastasis, nephrectomy, metastasectomy, and cytokine-based therapy seemed to improve the prognosis of RCC patients in the present study.
Naito
Sei
S
Department of Urology, Yamagata University, Yamagata 951-8510, Japan.
Yamamoto
Naoki
N
Takayama
Tatsuya
T
Muramoto
Masatoshi
M
Shinohara
Nobuo
N
Nishiyama
Kenryu
K
Takahashi
Atsushi
A
Maruyama
Ryo
R
Saika
Takashi
T
Hoshi
Senji
S
Nagao
Kazuhiro
K
Yamamoto
Shingo
S
Sugimura
Issei
I
Uemura
Hirotsugu
H
Koga
Shigehiko
S
Takahashi
Masayuki
M
Ito
Fumio
F
Ozono
Seiichiro
S
Terachi
Toshiro
T
Naito
Seiji
S
Tomita
Yoshihiko
Y
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000188:drug therapy / Q000401:mortality* / Q000556:secondary*; D002648:Child; D016207:Cytokines / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007564:Japan; D007680:Kidney Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
D016207:Cytokines