Abstract
The purpose of this article was to explore the association of tumor size with lymph node metastases (LNM) risk in patients with clear cell renal cell carcinoma (ccRCC). Based on the Surveillance, Epidemiology, and End Result (SEER) database, patients diagnosed with ccRCC from 1988 to 2015 were included in this study. For each patient, personal characteristics, clinicopathological data, and survival outcomes were, respectively, collected. Subsequently, the odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to investigate the potential risk factors for LNM in ccRCC. Finally, Kaplan-Meier (KM) survival plots of overall survival (OS) and ccRCC-specific survival (CSS) were evaluated on the basis of different tumor sizes. A total of 8,292 patients were finally enrolled in the study, 1,170 of whom (14.11%) had LNM. According to the heatmap, we could intuitively interpret that larger tumor size was related to an increased risk of LNM obviously. The risk of LNM was evidently greater for larger tumor size (4-7 cm: OR = 2.415, 95% CI = 1.708–3.415; 7–10 cm: OR = 3.746, 95% CI = 2.677–5.242; and >10 cm: OR = 4.617, 95% CI = 3.302–6.457) compared with smaller tumor size (≤4 cm). According to the KM survival plots of OS and CSS, we observed a gradual decline in survival with increasing tumor size, while the smallest tumor size had the best survival outcomes. These results indicated the positive relationship of tumor size with risk of LNM in ccRCC. And we also noticed continual decrease survival rates of OS and CSS with increasing tumor size.
Highlights
Kidney cancer remains a serious public health problem in the world. e estimated new cases and deaths in the United States in 2020 are 73,750 and 14,830, respectively [1]
Previous study reported that approximately 30% of Renal cell carcinoma (RCC) patients developed lymph node metastases (LNM) or distant metastases at their initial diagnosis [4]
A total of 8,292 clear cell RCC (ccRCC) patients were included in the study, 1,179 of whom (14.11%) had LNM
Summary
Kidney cancer remains a serious public health problem in the world. e estimated new cases and deaths in the United States in 2020 are 73,750 and 14,830, respectively [1]. Kidney cancer remains a serious public health problem in the world. Renal cell carcinoma (RCC) is the most common type of kidney cancer, and clear cell RCC (ccRCC) accounts for probably over 80% of all RCC cases [2]. Previous study reported that approximately 30% of RCC patients developed lymph node metastases (LNM) or distant metastases at their initial diagnosis [4]. Substantial researches have demonstrated that RCC patients with LNM may not benefit from nephrectomy and lymph node dissection (LND) [6, 7]. Some immunosuppressants and targeted drugs have been established as first-line therapy in metastatic RCC, the majority of patients still relapsed and died within several years [8]. Kroeger et al [9] reported that patients with LNM had worse prognosis compared to those without LNM even
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