Survival analysis of surgically treated renal cell carcinoma: an analysis of 10-year data from single center

Abstract

To explore how clinical features of renal cell carcinoma (RCC) relate to cancer patients' prognosis and survival. A total of 1 497 renal cell carcinoma patients received surgical treatments in Department of Urology, Peking Union Medical College were admitted between January 2002 and December 2012. Telephone interviews and complimentary medical records review were carried out to acquire follow-up data, including post-surgery adjuvant therapy, disease progression and survival. There were 1 326 of all 1 497 RCC cases successfully followed up, including 899 male and 427 female cases. The median age was 54(18) years (M(QR)). There were 1 049 T1 cases (79.11%), 139 T2 cases (10.48%), 125 T3 cases (9.43%), and 13 T4 cases (0.98%). As for types of surgery, there were 584 (44.04%) nephron-sparing surgery cases, and 742 (55.96%) radical nephrectomy cases. As for pathological subtypes, it included 1 153 (86.95%) clear cell renal cell carcinoma cases, and 173 (13.05%) non-clear cell renal cell carcinoma cases. Median length of follow-up was 43.6 months. During follow-up, 147 patients developed RCC related progression, with a median progression free survival of 18.2 months.Sixty-four patients died from RCC related progression, with a median cancer specific survival (CSS) of 27.7 months. RESULTS of data analysis showed that CSS rates of 1-, 5-, 10-year of T1 stage post-surgical RCC were 99.61%, 97.24%, 92.08%, respectively; CSS rates of 1-, 5-, 10-year of T2 stage were 98.51%, 92.01%, 85.08%, respectively; and CSS rates of 1-, 5-, 10-year of T3-4 stage were 92.40%, 77.99%, 42.56%, respectively. Multivariable Cox regression analysis showed that signs of lung metastasis, signs of bone metastasis, tumor N stage, pathological subtype, microscopic sarcomatoid changing, and types of progression were major risk factors for RCC cancer specific survival (P<0.05). Surgery is the primary choice of treatment in RCC. The survival is not same with different T stage. T stage affects the progression of renal cell carcinoma. N stage, lung and bone symptoms, pathological type, sarcomatoid changes and postoperative metastasis of renal cell carcinoma will affect the mortality of patients.