title: Prognosis of Japanese metastatic renal cell carcinoma patients in the cytokine era: a cooperative group report of 1463 patients.
abstract: 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.
authors.affiliation: Department of Urology, Yamagata University, Yamagata 951-8510, Japan.
authors.forename: Sei
authors.initials: S
authors.lastname: Naito
authors.forename: Naoki
authors.initials: N
authors.lastname: Yamamoto
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Takayama
authors.forename: Masatoshi
authors.initials: M
authors.lastname: Muramoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Shinohara
authors.forename: Kenryu
authors.initials: K
authors.lastname: Nishiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Takahashi
authors.forename: Ryo
authors.initials: R
authors.lastname: Maruyama
authors.forename: Takashi
authors.initials: T
authors.lastname: Saika
authors.forename: Senji
authors.initials: S
authors.lastname: Hoshi
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Nagao
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Issei
authors.initials: I
authors.lastname: Sugimura
authors.forename: Hirotsugu
authors.initials: H
authors.lastname: Uemura
authors.forename: Shigehiko
authors.initials: S
authors.lastname: Koga
authors.forename: Masayuki
authors.initials: M
authors.lastname: Takahashi
authors.forename: Fumio
authors.initials: F
authors.lastname: Ito
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Ozono
authors.forename: Toshiro
authors.initials: T
authors.lastname: Terachi
authors.forename: Seiji
authors.initials: S
authors.lastname: Naito
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Tomita
mesh_terms: 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
chemical_list: D016207:Cytokines