Factores pronósticos del carcinoma de células renales

López, R.A. Medina; Sánchez, Javier Sánchez; Ruiz, C.B. Congregado; Resina, R. González; Navarro, Salvador Mármol; Romero, Francisco Javier Torrubia

doi:10.1016/s0210-4806(09)74192-0

Cited by 8 publications

(4 citation statements)

References 72 publications

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“…Prognostic factors for RCC have been investigated and studied. Factors can be classified according to clinical, molecular and anatomical, histopathological [ 15 ]. The European Association of Urology guidelines advise use of the TNM classification, Fuhrman nuclear grade, and histological subtype for treatment of RCC.…”

Section: Discussionmentioning

confidence: 99%

Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

Choi

Song

2016

Investig Clin Urol

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PurposeThe aim of this study was to examine the association of preoperative thrombocytosis with the prognosis of patients with nonmetastatic renal cell carcinoma (RCC).Materials and MethodsWe conducted a retrospective analysis of 187 patients who underwent a radical nephrectomy for nonmetastatic RCC between July 1997 and June 2009. Thrombocytosis was defined as a platelet count≥400,000 µL, and patients were divided into 2 groups according to presence of preoperative thrombocytosis, and the cancer-specific survival rates and overall survival rates of the 2 groups after radical nephrectomy were compared.ResultsThe mean age of the patients was 56.0±11.7 years and the mean follow-up period was 59.3±42.1 months; there were 20 patients with preoperative thrombocytosis. Thirty patients developed metastases and 9 patients died during the follow-up period. In Kaplan-Meier analysis using a univariate log-rank test, both cancer-specific survival rate (p=0.013) and overall survival rate (p=0.012) showed significant association with preoperative thrombocytosis. Controlling for pathological TNM stage, Fuhrman grade and tumor diameter, the Cox proportional hazards model for cancer-specific survival rates showed that preoperative thrombocytosis was an independent prognostic factor (p=0.025).ConclusionsPreoperative thrombocytosis was associated with poorer prognosis in patients with nonmetastatic RCC. Thus, preoperative platelet count may be clinically useful for risk stratification of patients undergoing surgery for nonmetastatic RCC.

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Section: Discussionmentioning

confidence: 99%

Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

Choi

Song

2016

Investig Clin Urol

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“…Currently, although many nomograms have been developed, their accuracy and practical application are highly disputed [25] . Therefore, the development of models that are more predictive and accurate is necessary, and various strategies should be employed to improve the models and their predictive power.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Nomogram for Disease-Free Survival in Patients with Renal Adenocarcinoma

Sacoto¹,

Alba²,

Fadrique³

et al. 2012

Urol Int

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Objective: The aim of this study was to develop a postoperative prognostic nomogram for disease-free survival in patients with renal adenocarcinoma. Materials and Methods: A total of 224 patients with organ-confined or locally advanced renal adenocarcinoma were treated with radical or partial nephrectomy. The variables included in the model were age, histological type, pathological stage, Fuhrman grade and DNA ploidy. Tumor recurrence was defined as any clinical evidence of recurrence. The probability of progression-free survival was calculated using the Kaplan-Meier estimate, and multivariate analysis was performed using a Cox regression. The nomogram was created using the data obtained from the Cox regression. Results: Tumor recurrence was detected in 89 patients (39.74%). The median progression-free time in these patients was 9.55 months (range 0–133). Of these patients, 70.9% relapsed during the first 2 years, and only 15 patients (6.9%) were alive but ill at the end of the study. The probability of progression-free survival at 5 and 10 years was 66.64 and 61.97%, respectively. We performed a statistical validation of the model with accurate predictions that were discriminated with a confidence interval of 0.75 (comparing the predicted and actual probability). According to the nomogram obtained, patients with low-grade, diploid, organ-confined tumors would be candidates for follow-up not exceeding 5 years due to the low probability of recurrence (<40 points). Conclusion: The nomogram we developed is clinically relevant and can provide prognostic information for both patients and researchers. In addition, it can be used by researchers during the monitoring protocols that categorize patients based on their relative risk of disease progression.

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“…Todos los estudios anatomopatológicos fueron reevaluados por un único anatomopatólogo y reclasificados según la clasificación TNM (UICC 2002) 7 .…”

Section: Materials Y Métodosunclassified

“…Se analizaron 5 variables anatomopatológicas en todos los casos: clasificación TNM (UICC 2002) 7 , sistema de gradación de Fuhrman 8 , necrosis tumoral, invasión microvascular e invasión del seno renal ( fig. 1).…”

Section: Materials Y Métodosunclassified

Indicadores pronósticos anatomopatológicos del cáncer de riñón

et al. 2010

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analizar el valor pronóstico independiente de supervivencia de factores anatomopatológicos no valorados de modo rutinario, como necrosis tumoral, invasión microvascular e invasión del seno renal. Material y métodos: se realizó un estudio retrospectivo y analítico incluyendo las piezas de 139 cánceres renales, intervenidos entre enero de 1993 y diciembre de 2005, clínicamente localizados. Las variables analizadas fueron: necrosis tumoral, invasión microvascular e invasión del seno renal. Se compararon con los factores clásicos: clasificación TNM, gradación de Fuhrman y tamaño tumoral. Para el análisis estadístico las variables analizadas fueron categorizadas en: pT1,2 frente a pT3,4, Fuhrman 1,2 frente a 3,4, diámetro tumoral < 7 cm frente a diámetro tumoral ≥ 7, necrosis tumoral frente a no necrosis tumoral, invasión microvascular frente a no invasión microvascular e invasión del seno renal frente a no invasión del seno renal. Se calculó la probabilidad de supervivencia cáncer específica y el periodo libre de enfermedad. Se realizó el análisis estadístico descriptivo y analítico con el empleo de regresión logística para análisis univariante y multivariante. El periodo libre de enfermedad se estimó mediante el modelo de regresión de Cox y curvas de Kaplan-Meier. Resultados: en el análisis univariante todas las variables analizadas influyen de forma significativa en la muerte por cáncer de riñón. En el análisis multivariante la variable que más influye es el grado de Fuhrman (p = 0,032). En el periodo libre de enfermedad estimado por el método de Cox las variables que influyen de forma significativa son la categoría pT (p = 0,038) y el grado de Fuhrman (p = 0,048). Conclusión: en pacientes con cáncer renal clínicamente localizado la categoría pT y el grado de Fuhrman son los factores pronósticos anatomopatológicos más importantes en cuanto a la supervivencia y el periodo libre de enfermedad. La invasión microvascular, la necrosis tumoral y la invasión tumoral del seno renal son factores pronósticos de muerte por cáncer renal que se asocian con la categoría TNM, el grado de Fuhrman y tamaño tumoral.

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Factores pronósticos del carcinoma de células renales

Cited by 8 publications

References 72 publications

Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

Clinical significance of preoperative thrombocytosis in patients who underwent radical nephrectomy for nonmetastatic renal cell carcinoma

Prognostic Nomogram for Disease-Free Survival in Patients with Renal Adenocarcinoma

Indicadores pronósticos anatomopatológicos del cáncer de riñón

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