title: [Epidemiological and clinico-pathological characteristics of patients with renal carcinoma: a single institution analysis of 544 cases].
abstract: BACKGROUND
  The incidence of renal cell carcinoma in the Czech Republic is one of the highest in the world. Curative treatment is still possible only surgically, while in the palliative treatment, partial success was reached using targeted therapies. While prognostic factors and models are commonly used in clinical practice, unfortunately, predictive biomarkers have not been found. The aim of our study was to verify the validity of selected prognostic factors on a consecutive patient cohort from the Czech population.
  
  
  METHODS
  The patient cohort consisted of 544 patients with RCC diagnosed and/or treated at our institute from 2003 to 2010. Individual clinical and histological prognostic factors and Heng prognostic model were validated.
  
  
  RESULTS
  Median time of follow-up for our cohort was 42 months (range 0.3-326 months), median age at diagnosis was 62 years, and almost 64% of patients were men. Distribution of clinical stages was as follows: 46.5% of I, II. 10.7%, III. 13.1%, IV. 20%. 26.4% of patients in stage I-III relapsed. We diagnosed mainly clear cell (84.6%) and papillary carcinoma (9.2%). Initially, 95.8% of patients underwent surgical treatment, systemic adjuvant and palliative treatment was applied in 3.7 and 37.7% of patients, respectively. Palliative targeted therapy was received by a total of 163 patients (30%). In first-line targeted therapy, the following median TTP was reached (in months): 10.8 for sunitinib, 6.3 for sorafenib and 5.2 months for immunotherapy. The most significant prognostic factors (p < 0.00001) were: stage of disease (HR = 9.61), size of the primary tumor (HR = 5.83), lymph nodes (HR = 8.26), presence of sarcomatoid tumor sections in the tumor (HR = 7.29), and tumor grade (HR = 4.0). Besides these, we also confirmed the prognostic importance of presence of eosinophilic granulations in the tumor (HR = 1.91, p = 0.02). When applying the Heng prognostic model, we achieved similar results for patients treated with targeted therapies.
  
  
  CONCLUSIONS
  The obtained epidemiological and clinico-pathological data are consistent with previously published data. These prognostic factors can be used for a differentiated approach to patients with RCC, both for establishing follow-up plan for patients after surgery as well as indication for targeted therapies.
authors.affiliation: Klinika komplexni onkologicke pece, masarykuv onkologicky ustav, Brno.
authors.forename: A
authors.initials: A
authors.lastname: Poprach
authors.forename: R
authors.initials: R
authors.lastname: Lakomý
authors.forename: I
authors.initials: I
authors.lastname: Selingerová
authors.forename: B
authors.initials: B
authors.lastname: Dolečková
authors.forename: O
authors.initials: O
authors.lastname: Bílek
authors.forename: O
authors.initials: O
authors.lastname: Slabý
authors.forename: R
authors.initials: R
authors.lastname: Héžová
authors.forename: P
authors.initials: P
authors.lastname: Fabian
authors.forename: M
authors.initials: M
authors.lastname: Staník
authors.forename: T
authors.initials: T
authors.lastname: Pavlík
authors.forename: Z
authors.initials: Z
authors.lastname: Bortlíček
authors.forename: H
authors.initials: H
authors.lastname: Mlčochová
authors.forename: D
authors.initials: D
authors.lastname: Tkáč
authors.forename: R
authors.initials: R
authors.lastname: Vyzula
authors.forename: I
authors.initials: I
authors.lastname: Kiss
authors.forename: I
authors.initials: I
authors.lastname: Kocák
authors.forename: I
authors.initials: I
authors.lastname: Kocáková
authors.forename: M
authors.initials: M
authors.lastname: Svoboda
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged