Introduction and Objectives
The aim of this study was to evaluate influence of tumor diameter on cancer specific and overall survival after surgery of renal carcinoma.
Material and Methods
All patients who had undergone surgical treatment because of renal carcinoma (RCa) since Jan 1998 to Dec 2004 were included into this retrospective single institution study. Data on tumor size, grade, stage and histology were collected from pathological reports. All tumors were divided into four groups according diameter: 1st group ≤4 cm; 2nd group 4–7 cm; 3rd group 7–10 m and 4th group >10 cm. Exclusion criteria were benign tumor and known metastasis at the time of the surgery. Data about patient's death and reasons of the death were received from national cancer registry. Statistical analysis was performed using descriptive statistic, Kaplan-Meier and Cox regression.
Results
438 cases were included into the study. The median patients’ age was 64 ± 10.45 (range 26–85) years. 56.5% males and 43.5% females were operated. Stage pT1 was detected in 45%, pT2 – 20.4%, pT3 – 33.7% and pT4 – 0.9% of cases. The grade G1 was found in 28.5%, G2 – 54.7% and G3 – 16.8% of cases. The median follow-up was 67 ± 34.14 (0–129) months. The clear cells carcinoma was identified in 83.6%, papillary carcinoma – 4.8% and transition cells in 3.4% of cases. The median tumor size was 5.0 ± 2.67 (1.0–22.0) cm. Tumor ≤4 cm. was detected in 36.7%, 4–7 cm. – 39.6%, 7–10 cm. – 19.2% and >10 cm. in 4.6% of cases. During follow-up 151 (34.5%) of all patients died: 90 (20.6%) because of RCa and 61 (14.0%) because of other diseases. Cox regression shows that tumor size is one of the most important parameters influencing cancer specific survival (p = 0.006, Exp(B) 1.574, 95.0% CI 1.14–2.17). Overall survival at median follow-up of 67 months was 65.9%. Median follow-up of 1st and 2nd groups patients was 70, 3rd group – 60 and 4gr. – 31 months. Overall survival according size and follow-up was: 1st group – 73.9%, 2nd – 69.1%, 3rd – 53.8% and 4th – 26.3%. Overall cancer specific survival was 80.0%. In the different study groups specific survival was 90.1% vs. 80.0% vs. 71.3% vs. 36.8% respectively.
Conclusions
Overall as well as cancer specific survival strongly depends on tumor size. At seventy months follow up cancer specific survival for ≤4 cm. tumors reaches 90.1% of patients when only 36.8% of patients survive thirty one month with tumor >10 cm.
Article info
Identification
Copyright
© 2009 European Association of Urology. Published by Elsevier Inc. All rights reserved.
