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Oncological and functional outcomes after radical nephrectomy for renal cell carcinoma: A comprehensive analysis of prognostic factors
Author(s) -
Sejima Takehiro,
Iwamoto Hideto,
Masago Toshihiko,
Morizane Shuichi,
Hinata Nobuyuki,
Yao Akihisa,
Isoyama Tadahiro,
Saito Motoaki,
Takenaka Atsushi
Publication year - 2013
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.1442-2042.2012.03176.x
Subject(s) - medicine , nephrectomy , renal cell carcinoma , renal function , urology , pathological , univariate analysis , proportional hazards model , stage (stratigraphy) , carcinoma , kidney cancer , multivariate analysis , kidney , surgery , paleontology , biology
Objectives To investigate mortality rates and to comprehensively analyze prognostic indicators after radical nephrectomy for renal cell carcinoma. Methods Data were collected from 147 patients who underwent potentially curative radical nephrectomy for renal cell carcinoma. The following data were analyzed: tumor pathology, patient demographics and clinical parameters, such as pre‐ and postoperative estimated glomerular filtration rate, as well as the cause of death. Cause‐specific survival rates were calculated including deaths caused by renal cell carcinoma and cardiovascular disease. A Cox proportional hazard model was used for statistical analysis. Results A univariate analysis showed that age at surgery (≥70 years), postoperative estimated glomerular filtration rate (<45 mL/min/1.73 m 2 ), pathological high T stage, grade and venous invasion were significant poor prognostic indicators. The multivariate analysis provided evidence that pathological venous invasion was a significant poor prognostic indicator, whereas age at surgery (≥70 years), pre‐ (<65 mL/min/1.73 m 2 ) or postoperative (<45 mL/min/1.73 m 2 ) estimated glomerular filtration rate and pathological high grade were significant poor prognostic indicators in T1 tumor cases. Conclusions Post‐radical nephrectomy renal function insufficiency can lead to a poor prognostic outcome, especially in patients with T1 renal cell carcinoma. Physicians should consider a comprehensive follow up focusing on possible causes of death, including those related to both renal cell carcinoma and cardiovascular disease events after radical nephrectomy.