Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy

Abstract This retrospective, five-multicenter study was aimed to evaluate the prognostic impact of pathologic nodal positivity on recurrence-free (RFS), metastasis-free (MFS), overall (OS), and cancer-specific (CSS) survivals in patients with non-metastatic renal cell carcinoma (nmRCC) who underwent...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Sung Han Kim, Boram Park, Eu Chang Hwang, Sung-Hoo Hong, Chang Wook Jeong, Cheol Kwak, Seok Soo Byun, Jinsoo Chung
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/5d9e1514496e409baade7726c198905b
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:5d9e1514496e409baade7726c198905b
record_format	dspace
spelling	oai:doaj.org-article:5d9e1514496e409baade7726c198905b2021-12-02T14:06:11ZPrognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy10.1038/s41598-021-82750-y2045-2322https://doaj.org/article/5d9e1514496e409baade7726c198905b2021-02-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-82750-yhttps://doaj.org/toc/2045-2322Abstract This retrospective, five-multicenter study was aimed to evaluate the prognostic impact of pathologic nodal positivity on recurrence-free (RFS), metastasis-free (MFS), overall (OS), and cancer-specific (CSS) survivals in patients with non-metastatic renal cell carcinoma (nmRCC) who underwent either radical or partial nephrectomy with/without LN dissection. A total of 4236 nmRCC patients was enrolled between 2000 and 2012, and followed up through the end of 2017. Survival measures were compared between 52 (1.2%) stage pT1-4N1 (LN+) patients and 4184 (98.8%) stage pT1-4N0 (LN−) patients using Kaplan–Meier analysis with the log-rank test and Cox regression analysis to determine the prognostic risk factors for each survival measure. During the median 43.8-month follow-up, 410 (9.7%) recurrences, 141 (3.3%) metastases, and 351 (8.3%) deaths, including 212 (5.0%) cancer-specific deaths, were reported. The risk factor analyses showed that predictive factors for RFS, CSS, and OS were similar, whereas those of MFS were not. After adjusting for significant clinical factors affecting survival outcomes considering the hazard ratios (HR) of each group, the LN+ group, even those with low pT stage, had similar to or worse survival outcomes than the pT3N0 (LN−) group in multivariable analysis and had significantly more relationship with RFS than MFS. All survival measures were significantly worse in pT1-2N1 patients (MFS/RFS/OS/CSS; HR 4.12/HR 3.19/HR 4.41/HR 7.22) than in pT3-4N0 patients (HR 3.08/HR 2.92/HR 2.09/HR 3.73). Therefore, LN+ had an impact on survival outcomes worse than pT3-4N0 and significantly affected local recurrence rather than distant metastasis compared to LN− in nmRCC after radical or partial nephrectomy.Sung Han KimBoram ParkEu Chang HwangSung-Hoo HongChang Wook JeongCheol KwakSeok Soo ByunJinsoo ChungNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-11 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Sung Han Kim Boram Park Eu Chang Hwang Sung-Hoo Hong Chang Wook Jeong Cheol Kwak Seok Soo Byun Jinsoo Chung Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
description	Abstract This retrospective, five-multicenter study was aimed to evaluate the prognostic impact of pathologic nodal positivity on recurrence-free (RFS), metastasis-free (MFS), overall (OS), and cancer-specific (CSS) survivals in patients with non-metastatic renal cell carcinoma (nmRCC) who underwent either radical or partial nephrectomy with/without LN dissection. A total of 4236 nmRCC patients was enrolled between 2000 and 2012, and followed up through the end of 2017. Survival measures were compared between 52 (1.2%) stage pT1-4N1 (LN+) patients and 4184 (98.8%) stage pT1-4N0 (LN−) patients using Kaplan–Meier analysis with the log-rank test and Cox regression analysis to determine the prognostic risk factors for each survival measure. During the median 43.8-month follow-up, 410 (9.7%) recurrences, 141 (3.3%) metastases, and 351 (8.3%) deaths, including 212 (5.0%) cancer-specific deaths, were reported. The risk factor analyses showed that predictive factors for RFS, CSS, and OS were similar, whereas those of MFS were not. After adjusting for significant clinical factors affecting survival outcomes considering the hazard ratios (HR) of each group, the LN+ group, even those with low pT stage, had similar to or worse survival outcomes than the pT3N0 (LN−) group in multivariable analysis and had significantly more relationship with RFS than MFS. All survival measures were significantly worse in pT1-2N1 patients (MFS/RFS/OS/CSS; HR 4.12/HR 3.19/HR 4.41/HR 7.22) than in pT3-4N0 patients (HR 3.08/HR 2.92/HR 2.09/HR 3.73). Therefore, LN+ had an impact on survival outcomes worse than pT3-4N0 and significantly affected local recurrence rather than distant metastasis compared to LN− in nmRCC after radical or partial nephrectomy.
format	article
author	Sung Han Kim Boram Park Eu Chang Hwang Sung-Hoo Hong Chang Wook Jeong Cheol Kwak Seok Soo Byun Jinsoo Chung
author_facet	Sung Han Kim Boram Park Eu Chang Hwang Sung-Hoo Hong Chang Wook Jeong Cheol Kwak Seok Soo Byun Jinsoo Chung
author_sort	Sung Han Kim
title	Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
title_short	Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
title_full	Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
title_fullStr	Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
title_full_unstemmed	Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
title_sort	prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/5d9e1514496e409baade7726c198905b
work_keys_str_mv	AT sunghankim prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT borampark prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT euchanghwang prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT sunghoohong prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT changwookjeong prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT cheolkwak prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT seoksoobyun prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy AT jinsoochung prognosticsignificanceofpathologicnodalpositivityinnonmetastaticpatientswithrenalcellcarcinomawhounderwentradicalorpartialnephrectomy
_version_	1718392022549659648

Prognostic significance of pathologic nodal positivity in non-metastatic patients with renal cell carcinoma who underwent radical or partial nephrectomy

Ejemplares similares