title: Cytoreductive nephrectomy for pT3b-T4 M1 renal cell carcinoma in 39 patients: single center analysis.
abstract: We reviewed cytoreductive nephrectomy for pT3b-T4 renal cell carcinoma with metastasis and evaluated the prognostic factors for cancer-specific survival. A total of 39 patients who underwent cytoreductive nephrectomy for renal cell carcinoma with pathological T3b-T4 (2009 Union for International Cancer Control consensus) from 1986 to 2011 in our hospital were the participants in this study. Prognostic factors for cancer-specific survival were analyzed. The median patient age was 64 years (range 31-84). Pathological T3b, T3c and T4 were found in 24 (61%), one (3%) and 14 (36%) patients, respectively. The distribution of the histological type was clear cell type in 34 (87%), papillary type in two (5%) and any type of renal cell carcinoma with a sarcomatoid component in three patients (8%). The median overall and cancer-specific survival was 7.5 and 7.6 months, respectively. Low-grade performance status, regional lymph node metastasis, higher pT stage and histological type were prognostic factors for cancer-specific survival on univariate analysis. On multivariate analysis, lymph node metastasis, higher pT stage and histological type (non-clear cell or sarcomatoid component) were significant predictors for cancer-specific survival. With cytoreductive nephrectomy for patients with pT4, lymph node metastasis and non-clear cell histology, we have to be particularly careful in terms of cancer control.
authors.affiliation: Department of Urology, Tokyo Women’s Medical University, Tokyo, Japan. himmeno1192@yahoo.co.jp
authors.forename: Toshio
authors.initials: T
authors.lastname: Takagi
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Kondo
authors.forename: Junpei
authors.initials: J
authors.lastname: Iizuka
authors.forename: Hirohito
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Yasunobu
authors.initials: Y
authors.lastname: Hashimoto
authors.forename: Kazunari
authors.initials: K
authors.lastname: Tanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000379:methods; D011379:Prognosis; D012307:Risk Factors; D016019:Survival Analysis