The impact of angiogenesis on the prognosis of advanced renal cell carcinomas

Abstract

著者らの施設において腎細胞癌の診断で腎摘除を行った148例中32例を対象に, 進行性腎細胞癌における血管新生因子, および治療に奏功した症例と進行した症例の相違について検討した.その結果, 1年, 5年そして10年生存率は各々82.4%, 30%, 30%であった.奏功症例(group A)は計4例で肺転移は3例に認められ, 2例に著効そして1例が有効であった.骨転移1例は有効であった.13例には奏功所見は認められなかった(group B).Thymidine Phosphorylaseはgroup Aがgroup Bより陽性率が高く, また多変量解析の結果, positive mean vascular areaが進行腎細胞癌における遠隔成績に影響をおよぼす独立した因子であることが示された

We studied the relationship between angiogenic factors and clinical responses in advanced renal cell carcinomas (RCCs) and evaluated the angiogenic factors to clarify the potential impact of these factors on the cancer-specific survival. From January 1990 to December 2000, 148 patients underwent a nephrectomy for RCCs at our institution. Of the 32 patients who had distant metastasis, 17 met the histopathologic analysis requirements for an immuno-histochemical investigation. Fifteen of them were administered interferon-gamma and the remaining two patients were added to interferon-alpha and eight of seventeen patients also underwent radiation therapy. Both thymidine phosphorylase (TP) and Factor VIII immunostaining were performed. The overall survival rates at 1, 5 and 10 years were 82.4%, 30% and 30%, respectively. Three of these patients were diagnosed with lung metastasis and a complete response was seen in two, while a partial response was observed in one. In addition another patient who was diagnosed with bone metastasis also showed a partial response (group A). The remaining 13 patients showed progressive disease (group B). Group A had a higher TP-positive ratio (TP-PR) than that of group B. A multivariate analysis of the clinicopathologic data showed that a positive mean vascular area (PMVA) could be an independent factor regarding the potential impact of these factors on a long survival in advanced RCCS. PMVA was thus found to be an independent factor regarding the prognosis with advanced RCCs.