Retrospective Multicenter Long-Term Follow-up Analysis of Prognostic Risk Factors for Recurrence-Free, Metastasis-Free, Cancer-Specific, and Overall Survival After Curative Nephrectomy in Non-metastatic Renal Cell Carcinoma

Kim, Sung-Han; Park, Boram; Hwang, Eu Chang; Hong, Sung Hoo; Jeong, Chang Wook; Kwak, Cheol; Byun, Seok Soo; Chung, Jinsoo

doi:10.3389/fonc.2019.00859

Cited by 29 publications

(17 citation statements)

References 31 publications

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“…Previously, anaemia has been suggested as a prognostic factor in RCC. Kim et al retrospectively analysed data of 4260 patients that had non-metastatic RCC and found anaemia was highly associated with worse recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS) [ 17 ]. Jiwei Huang et al analysed the data of 352 papillary RCC patients and found that patients with preoperative anaemia had significantly worse RFS, CSS, and OS than those without it (P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Preoperative anaemia and thrombocytosis predict adverse prognosis in non‐metastatic renal cell carcinoma with tumour thrombus

Xiao

et al. 2021

BMC Urol

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Background This study aimed to determine the prognostic value of preoperative blood parameters in renal cell carcinoma (RCC) and tumour thrombus (TT) patients that were surgically treated. Method We retrospectively analysed clinicopathological data and blood parameters of 146 RCC and TT patients that were surgically treated. Univariate or multivariate Cox regression analyses were performed to determine the risk factors associated with progression-free survival (PFS) and overall survival (OS). Kaplan-Meier analysis and logistic regression were performed to study the risk factors. Receiver operating characteristic curves were applied to test improvements in the predictive accuracy of the established prognosis score. Results On univariate and multivariate analysis, anaemia (HR 2.873, P = 0.008) and lymph node metastasis (HR 4.811, P = 0.015) were independent prognostic factors linked to OS. Besides, thrombocytosis (HR 2.324, P = 0.011), histologic subtype (HR 2.835, P = 0.004), nuclear grade (HR 2.069, P = 0.033), and lymph node metastasis (HR 5.739, P = 0.001) were independent prognostic factors associated with PFS. Kaplan–Meier curves revealed that patients with anaemia exhibited worse OS than those without it (P = 0.0033). Likewise, patients with thrombocytosis showed worse PFS than those without it (P < 0.0001). Adding the anaemia and thrombocytosis to the SSIGN score improved its predictive accuracy related to OS and PFS. Preoperative anaemia was linked to more symptom at presentation (OR 3.348, P = 0.006), longer surgical time (OR 1.005, P = 0.001), more blood loss (OR 1.000, P = 0.018), more transfusion (OR 2.734, P = 0.004), higher thrombus level (OR 4.750, P = 0.004) and higher nuclear grade (OR 3.449, P = 0.001) while thrombocytosis was associated with more symptom at presentation (OR 7.784, P = 0.007). Conclusions Preoperative anaemia and thrombocytosis were adverse prognostic factors in non-metastatic RCC patients with TT. Also, both preoperative anaemia and thrombocytosis can be clinically used for risk stratification of non-metastatic RCC and TT patients.

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Section: Discussionmentioning

confidence: 99%

Preoperative anaemia and thrombocytosis predict adverse prognosis in non‐metastatic renal cell carcinoma with tumour thrombus

Xiao

et al. 2021

BMC Urol

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“…In the previous study, anemia could be used as a prognostic factors in RCC. Kim SH et al retrospectively analyzed 4,260 patients with non-metastatic RCC and found factors include anemia were associated with worse recurrence-free survival (RFS), cancer-speci c survival (CSS), and overall survival (OS) [16]. Jiwei Huang et al analyzed 352 patients with papillary RCC and found patients with preoperative anemia had signi cantly worse RFS, CSS, and OS than patients without anemia (P < 0.001).…”

Section: Discussionmentioning

confidence: 99%

Preoperative Anemia and Thrombocytosis Predict Adverse Prognosis in Non-Metastatic Renal Cell Carcinoma With Tumor Thrombus

Ruotao

Chuxiao

et al. 2020

Preprint

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Objection: The aim of the study was to determine the prognostic value of preoperative blood parameters in patients with renal cell carcinoma (RCC) and tumor thrombus (TT) treated surgically.Method: we retrospectively analyzed 152 patients diagnosis with RCC and TT and treated surgically. Clinicopathologic data and blood parameter were obtained. Univariable and multivariable analysis using the Cox regression model were performed to determine risk factors that were associated with progression-free survival (PFS) and overall survival (OS). Kaplan-Meier curve and logistic regression were performed to analyze the risk factors.Results: Preoperative Hgb＜120g/L (HR=2.48, P=0.024) and lymph node metastasis (HR=3.98, P=0.032) were an independent prognostic factors associated with OS. Preoperative PLT≥300×109/L (HR=2.10, P=0.014) and lymph node metastasis (HR=3.42, P=0.021) were an independent prognostic factors associated with PFS. In Kaplan–Meier survival analysis, preoperative anemia had worse OS than without anemia (P=0.003) and thrombocytosis had worse PFS than without thrombocytosis (P=0.001). Preoperative anemia were associated with more symptomatic (P=0.009), surgical time≥6h (P=0.016), Blood loss≥1000ml (P=0.014), transfusion(P=0.012), higher thrombus level (III-IV) (P=0.004) and higher nuclear grade (III-IV) (P=0.002) while thrombocytosis were associated with more symptomatic (P=0.008) and higher nuclear grade (III-IV) (P=0.042)Conclusions: Preoperative anemia and thrombocytosis was associated with adverse prognosis in patients with non-metastatic RCC with TT. Both preoperative hemoglobin level and platelet count may be clinical useful for risk stratifying patients receiving operation for non-metastatic RCC with TT.

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“…Almost half of the patients with clear cell renal cell carcinoma (ccRCC) develop metastases [1]. Even after surgical treatment of early non-metastatic kidney cancer, metastases occur in 5-15% of cases within five years of follow-up, which significantly affect the survival of patients [2]. The frequency of metastasis can be about three-fourths of all relapse cases and is weakly associated with some clinical characteristics [3].…”

Section: Introductionmentioning

confidence: 99%

The Genes—Candidates for Prognostic Markers of Metastasis by Expression Level in Clear Cell Renal Cell Cancer

et al. 2020

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The molecular prognostic markers of metastasis are important for personalized approaches to clear cell renal cell carcinoma (ccRCC) treatment but markers for practical use are still missing. To address this gap we studied the expression of ten genes—CA9, NDUFA4L2, VWF, IGFBP3, BHLHE41, EGLN3, SAA1, CSF1R, C1QA, and FN1—through RT-PCR, in 56 ccRCC patients without metastases and with metastases. All of these, excluding CSF1R, showed differential and increased (besides SAA1) expression in non-metastasis tumors. The gene expression levels in metastasis tumors were decreased, besides CSF1R, FN1 (not changed), and SAA1 (increased). There were significant associations of the differentially expressed genes with ccRCC metastasis by ROC analysis and the Fisher exact test. The association of the NDUFA4L2, VWF, EGLN3, SAA1, and C1QA expression with ccRCC metastasis is shown for the first time. The CA9, NDUFA4L2, BHLHE4, and EGLN3 were distinguished as the strongest candidates for ccRCC metastasis biomarkers. We used an approach that presupposed that the metastasis marker was the expression levels of any three genes from the selected panel and received sensitivity (88%) and specificity (73%) levels with a relative risk of RR > 3. In conclusion, a panel of selected genes—the candidates in biomarkers of ccRCC metastasis—was created for the first time. The results might shed some light on the ccRCC metastasis processes.

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Retrospective Multicenter Long-Term Follow-up Analysis of Prognostic Risk Factors for Recurrence-Free, Metastasis-Free, Cancer-Specific, and Overall Survival After Curative Nephrectomy in Non-metastatic Renal Cell Carcinoma

Cited by 29 publications

References 31 publications

Preoperative anaemia and thrombocytosis predict adverse prognosis in non‐metastatic renal cell carcinoma with tumour thrombus

Preoperative anaemia and thrombocytosis predict adverse prognosis in non‐metastatic renal cell carcinoma with tumour thrombus

Preoperative Anemia and Thrombocytosis Predict Adverse Prognosis in Non-Metastatic Renal Cell Carcinoma With Tumor Thrombus

The Genes—Candidates for Prognostic Markers of Metastasis by Expression Level in Clear Cell Renal Cell Cancer

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