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Cytoreductive nephrectomy for pT3b–T4 M1 renal cell carcinoma in 39 patients: Single center analysis
Author(s) -
Takagi Toshio,
Kondo Tsunenori,
Iizuka Junpei,
Kobayashi Hirohito,
Hashimoto Yasunobu,
Tanabe Kazunari
Publication year - 2012
Publication title -
international journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.172
H-Index - 67
eISSN - 1442-2042
pISSN - 0919-8172
DOI - 10.1111/j.1442-2042.2012.03038.x
Subject(s) - medicine , nephrectomy , renal cell carcinoma , oncology , cancer , urology , stage (stratigraphy) , kidney cancer , univariate analysis , metastasis , lymph node , clear cell renal cell carcinoma , pathology , multivariate analysis , kidney , paleontology , biology
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.