Multivariate analysis of prognostic determinants after surgery for renal cell carcinoma at Himeji National Hospital

Abstract

1992年1月から1998年10月までに, 国立姫路病院にて原発巣に対し外科的治療を施行した62症例を対象に, その臨床的, 病理学的予後因子の統計学的解析を行った.平均観察期間は32カ月であった.全体の1, 3, 5年疾患特異的生存率はそれぞれ86.7, 81.3, 81.3%であった。観察期間中, 癌死した症例は11例(17.7%)で, 2例(3.2%)は他因死した.単変量解析の結果, 症状の有無, CRP, ESR, ALP, 腫瘍径, 組織学的細胞異型度, 組織学的浸潤増殖様式, 病理学的病期, N分類, M分類が有意な予後因子であったが, 多変量解析では, ALP, N分類, M分類のみで有意に予後に関与しており, M分類が最も危険な因子であった。

A clinico-pathological study was performed retrospectively on 62 patients who underwent surgery for renal cell carcinoma between January 1992 and October 1998 at Himeji National Hospital to clarify the prognostic determinants for survival. The median follow-up period was 32 months and the cause-specific survival rates at 1, 3 and 5 years were 86.7, 81.3, 81.3%, respectively. Of the 62 patients, 11 (17.7%) patients died of renal cell carcinoma and 2 (3.2%) patients died of unrelated causes. Of the variables related to survival, presenting symptoms, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), alkaline phosphatase (ALP), tumor size, pathological tumor grade, infiltration pattern, pathological tumor stage, N classification and M classification were significant risk factors for survival by univariate analysis. However, ALP, N classification and M classification were significant for survival as determined by the step-wise procedure and M classification was the most significant factor according to Cox's proportional hazard model analysis.