Epidemiological and overall survival characteristics of kidney cancer patients in Ege University Hospital database
Öz
Aim: The purpose of this study was to describe the general characteristics, treatment modalities and
overall survival times of kidney cancer patients that diagnosed and treated in between 1992 –and
June 2018 at Ege University Hospital.
Materials and Methods: Ege University Cancer Control, Research and Application Center
registered the collected kidney cancer data in CANREG which is a special computer program for
grouping and analyzing the data in WHO and SEER based systems. Fisher’s Exact Test Kaplan
Meier survival analyzing technique was used in statistical analysis. Log Rank(Mantel-Cox),
Breslow(Generalized Wilcoxon) and Tarone-Ware statistical techniques were used in survival
analysis. P<0,05 was considered significant in statistical analysis.
Results: A total of 2180 kidney cancer patient (1397 male, 783 female) were included in the
analysis. The mean age of the patients was 65 years.91.9% of them originated from renal
parenchyma and 8,07% of them originated from renal pelvis. Approximately 85% of parenchymal
tumors constitute renal cell carcinoma (RCC). The most common histological subtype was clear
cell carcinoma, followed by papillary carcinoma and Wilms tumor. Among the histological
subtypes, the best 5-year survival was in chromophobe and Wilms tumor. There was no statistical
difference between clear cell RCC and other histological subtypes. The worst survival was
detected at sarcoma and collecting canal tumor patients. The most common presentation was
stage 1 (46.6%), followed by stage 4 (19.2%), stage 2 (14.9%), stage 3 (4%) disease. Five-year
survival was 88%, 65%, 27% and 10.4% in stage 1, 2, 3 and metastatic patients respectively. We
detected that 89% had undergone surgery for primary tumor, 10.4% had surgical intervention for
their disease, and 0.5% was unknown. Survival was significantly higher in the surgical group than
in the surgical group.
Conclusion: Clear cell carcinomas are the most common subtype and mostly malignant tumors.
Chromophobe and Wilms tumors are usually benign tumors and are associated with better
survival. Female sex and surgical treatment are associated with better survival.
Anahtar Kelimeler
Kaynakça
- SEER Stat Fact Sheets: Kidney and Renal Pelvis. http://seer.cancer.gov/statfacts/html/kidrp.html .
- Störkel S,van den Berg E. Morphological classification of renal cancer. World J Urol. 1995;13(3):153-8.
- Israel GM, Bosniak MA. How I do it: evaluating renal masses. Radiology, 236 (2), 441-50.
- Johnson CD, Dunnick NR, Cohan RH, Illescas FF. Renal adenocarcinoma: CT staging of 100 tumors. AJR Am J Roentgenol, 148 (1), 59-63.
- Koga S, Tsuda S, Nishikido M et al. The diagnostic value of bone scan in patients with renal cell carcinoma. J Urol, 166 (6), 2126-8.
- Ramdave S, Thomas GW, Berlangieri SU et al.Clinical role of F-18 fluorodeoxyglucose positron emission tomography for detection and management of renal cell carcinoma. J Urol. 2001 Sep;166(3):825-30.
- Novara G, Martignoni G, Artibani W, Ficarra V. Grading systems in renal cell carcinoma. J Urol. 2007 Feb;177(2):430-6.
- Cheville JC, Lohse CM, Zincke H et al. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003 May;27(5):612-24.
- Kassouf W, Sanchez-Ortiz R, Tamboli P et al. Cytoreductive nephrectomy for metastatic renal cell carcinoma with nonclear cell histology. . J Urol. 2007 Nov;178(5):1896-900. Epub 2007 Sep 17.
- Motzer RJ, Hutson TE, Tomczak P et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009 Aug 1;27(22):3584-90. doi: 10.1200/JCO.2008.20.1293. Epub 2009 Jun 1.
- Rini BI, Halabi S, Rosenberg JE et al. Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. . J Clin Oncol. 2010 May 1;28(13):2137-43. doi: 10.1200/JCO.2009.26.5561. Epub 2010 Apr 5.
Ege Üniversitesi Hastanesinde renal kanser hastalarının epidemiyolojisi ve genel sağ kalım özellikleri
Öz
Amaç: Ege Üniversitesi Hastanesinde 1992-Haziran 2018 arası kanser tanısı konan ve tedavisi
yapılan renal kanser tanılı hastaların genel özellikleri, tedavi modaliteleri ve sağ kalım sürelerinin
tanımlanması amaçlanmıştır.
Gereç ve Yöntem: Ege Üniversitesi Kanserle Savaş Araştırma ve Uygulama Merkezi tarafından
toplanan renal kanser verileri CANREG özel bilgisayar programına kayıt edilmiş, DSÖ ve SEER
sistemleri temelinde gruplanarak analizler yapılmıştır. İstatistik analizlerde Fisher’s Exact Test,KaplanMeier sağ kalım analizleri uygulanmıştır. Sağ kalım analizinde Log Rank (Mantel-Cox), Breslow
(Generalized Wilcoxon) ve Tarone-Ware istatistikleri kullanılmıştır. İstatistik analizlerde p<0,05
istatistiksel olarak anlamlı kabul edilmiştir.
Bulgular: Çalışmada 1397’si (%64,0) erkek ve 783’si (%35,9) kadın toplam 2180 renal kanser
hastasının verileri analiz edildi. Hastaların yaş ortalaması 65 idi. Tümörlerin %91,9’u renal
parankimden, %8,07’si renal pelvisten köken almıştı. Parankim tümörlerinin yaklaşık %85’ini renal
hücreli karsinom (RCC) oluşturmaktadır. En sık görülen histolojik alt tip berrak hücreli karsinom olup,
bunu nefroblastoma ve papiller karsinom izlemekteydi. Histolojik alt tipler arasında en iyi beş yıllık sağ
kalım kromofob ve nefroblastomada idi. Berrak hücreli RCC ile diğer histolojik alt tipler arasında
istatistiki fark yoktu. En kötü sağ kalım sarkom ve toplayıcı kanal tümörlerinde izlendi. Hastalar
başvuru anında en sık evre 1 (%46,6), sonra sırayla evre 4 (%19,2), evre 2 (%14,9), evre 3 (%4)
hastalık ile başvurmakta idi. Evre 1 hastalıkta beş yıllık sağ kalım %88, evre 2’de %65, evre 3’te %27
ve metastatik hastalıkta %17 idi. Hastaların %89 da primer tümöre yönelik cerrahi yapıldığı görüldü,
%10,4 hastada cerrahi uygulanmamıştı ve %0,5’i ise bilinmemekte idi. Cerrahi yapılanlarda sağ kalım,
yapılmayanlara göre anlamlı saptanmıştır.
Sonuç: Berrak hücreli karsinomlar en sık görülen alt tip olup çoğunlukla malign tümörlerdir. Kromofob
ve nefroblastoma ise genellikle benign tümörler olup daha iyi sağ kalım ile ilişkilidirler. Kadın cinsiyet
ve cerrahi tedavi uygulanması daha iyi sağ kalımla ilişkilidir.
Anahtar Kelimeler
Kaynakça
- SEER Stat Fact Sheets: Kidney and Renal Pelvis. http://seer.cancer.gov/statfacts/html/kidrp.html .
- Störkel S,van den Berg E. Morphological classification of renal cancer. World J Urol. 1995;13(3):153-8.
- Israel GM, Bosniak MA. How I do it: evaluating renal masses. Radiology, 236 (2), 441-50.
- Johnson CD, Dunnick NR, Cohan RH, Illescas FF. Renal adenocarcinoma: CT staging of 100 tumors. AJR Am J Roentgenol, 148 (1), 59-63.
- Koga S, Tsuda S, Nishikido M et al. The diagnostic value of bone scan in patients with renal cell carcinoma. J Urol, 166 (6), 2126-8.
- Ramdave S, Thomas GW, Berlangieri SU et al.Clinical role of F-18 fluorodeoxyglucose positron emission tomography for detection and management of renal cell carcinoma. J Urol. 2001 Sep;166(3):825-30.
- Novara G, Martignoni G, Artibani W, Ficarra V. Grading systems in renal cell carcinoma. J Urol. 2007 Feb;177(2):430-6.
- Cheville JC, Lohse CM, Zincke H et al. Comparisons of outcome and prognostic features among histologic subtypes of renal cell carcinoma. Am J Surg Pathol. 2003 May;27(5):612-24.
- Kassouf W, Sanchez-Ortiz R, Tamboli P et al. Cytoreductive nephrectomy for metastatic renal cell carcinoma with nonclear cell histology. . J Urol. 2007 Nov;178(5):1896-900. Epub 2007 Sep 17.
- Motzer RJ, Hutson TE, Tomczak P et al. Overall survival and updated results for sunitinib compared with interferon alfa in patients with metastatic renal cell carcinoma. J Clin Oncol. 2009 Aug 1;27(22):3584-90. doi: 10.1200/JCO.2008.20.1293. Epub 2009 Jun 1.
- Rini BI, Halabi S, Rosenberg JE et al. Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. . J Clin Oncol. 2010 May 1;28(13):2137-43. doi: 10.1200/JCO.2009.26.5561. Epub 2010 Apr 5.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Sağlık Kurumları Yönetimi |
| Bölüm | Ek |
| Yazarlar | |
| Yayımlanma Tarihi | 31 Aralık 2019 |
| Gönderilme Tarihi | 15 Şubat 2019 |
| Yayımlandığı Sayı | Yıl 2019 |