Prognostic significance of the mode of detection in renal tumours

BJU International - Tập 90 Số 4 - Trang 358-363 - 2002
Jean Jacques Patard1, Alejandro Rodríguez1, Nathalie Rioux-Leclercq2, F. Guillé1, Bernard Lobel1
1Departments of Urology and,
2Pathology, CHU, Rennes, France

Tóm tắt

Objective  To evaluate the mode of detection of 400 renal tumours as a prognostic factor compared with the usual clinical and pathological prognostic variables. Patients and methods  The data were reviewed for 400 patients operated for a renal tumour at our institution between 1984 and 1999, analysing the prognostic value of age, sex, tumour size, stage, grade, vein invasion, adrenal gland invasion, lymph node invasion, metastasis, and mode of detection (incidental or not). The survival rates were assessed using the Kaplan‐Meier method and log‐rank test, and the data evaluated using multivariate analysis with the Cox proportional‐hazard model. Results  In all, 151 (38%) renal tumours were discovered incidentally. There was no significant difference in the percentage of renal cell carcinoma found between the groups of patients discovered incidentally or not (94.4% vs 93.9%). Tumours were smaller in the incidental group (5.7 cm vs 8.7 cm, P  < 0.001). In the incidental group, 15.2% of the tumours were treated with partial nephrectomy, against 1.2% in the symptomatic group ( P  < 0.001). The specific survival was significantly better in patients with renal tumours discovered incidentally (log‐rank test, P  < 0.001). The multivariate analysis showed that the mode of detection, stage, grade, metastasis (all P  < 0.001), and lymphatic extension ( P   =  0.005) were independent prognostic factors. Conclusion  The incidental discovery of renal tumours gives a supplementary benefit to patients in terms of survival, and should be considered as a prognostic factor in addition to stage and grade.

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Tài liệu tham khảo

10.1046/j.1464-410x.2000.00708.x

10.1016/S0090-4295(97)00506-2

10.1001/jama.281.17.1628

10.1016/S0022-5347(17)64494-X

10.1016/s0090-4295(00)00655-5

10.1016/0090-4295(92)90006-I

10.1046/j.1464-410X.1996.00140.x

10.3109/00365599609182322

10.1200/JCO.2001.19.6.1649

10.1016/S0022-5347(05)65640-6

10.1002/(SICI)1097-0142(19970901)80:5<992::AID-CNCR26>3.0.CO;2-Q

10.1097/00000478-198210000-00007

10.1002/1097-0142(1971)28:5<1165::AID-CNCR2820280513>3.0.CO;2-G

10.1016/S0022-5347(17)47639-7

10.1159/000475189

10.1111/j.1464-410X.1993.tb00716.x

10.1016/S0022-5347(05)67892-5

10.1016/S0022-5347(17)41698-3

10.1016/S0022-5347(17)39667-2

10.1016/S0090-4295(00)00534-3

10.1046/j.1464-410X.1996.00536.x

10.1016/S0022-5347(05)66066-1

10.1016/S0022-5347(01)62052-4

10.1016/S0022-5347(05)67896-2

Licht MR, 1994, Nephron sparing surgery in incidental versus suspected renal cell carcinoma, J Urol, 152, 39, 10.1016/S0022-5347(17)32810-0

10.1111/j.1464-410X.1994.tb00417.x

10.1016/s0090-4295(01)00991-8

10.1148/radiology.197.3.7480724

10.1016/S0022-5347(05)67129-7

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BJU International

Tập 90 Số 4

358-363

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