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Prognosis after nephrectomy for renal cell carcinoma
E B Jakobsen1, J H Eickhoff, J P Andersen
1Department of Urology H, Copenhagen County Hospital, Gentofte, Denmark.
Scandinavian Journal of Urology and Nephrology
|September 1, 1994
Summary
This study on renal cell carcinoma (RCC) found that flank pain and hematuria were common symptoms, but the classic triad was rare. Robson stage and elevated ESR significantly predicted patient survival after nephrectomy.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Renal cell carcinoma (RCC) is a significant health concern.
- Nephrectomy is a primary treatment for RCC.
- Understanding prognostic factors is crucial for patient outcomes.
Purpose of the Study:
- To analyze clinical presentation, survival rates, and prognostic factors in patients undergoing nephrectomy for RCC.
- To compare the efficacy of Robson stage and TNM staging systems in predicting survival.
Main Methods:
- Retrospective analysis of 177 males and 81 females who underwent nephrectomy for RCC between 1977-1988.
- Evaluation of presenting symptoms, including flank pain, hematuria, and the classical triad.
- Survival analysis using univariate and multivariate Cox regression, incorporating Robson stage, TNM stage, ESR, and anemia.
Main Results:
- Flank pain (54%) and hematuria (53%) were the most frequent symptoms; the classical triad was present in only 6% of patients.
- Overall 2- and 5-year survival rates were 0.55 and 0.41, respectively; RCC-specific survival rates were 0.59 and 0.49.
- Univariate analysis identified increasing T stage, positive N or M stage, Robson stage, elevated ESR, anemia, and blood transfusion as detrimental factors.
- Multivariate analysis revealed Robson stage and ESR as the only statistically significant predictors of survival.
Conclusions:
- Robson stage and elevated ESR are key prognostic indicators for renal cell carcinoma patients post-nephrectomy.
- Robson staging provides a simpler yet effective alternative to TNM staging for survival prediction in RCC.
- Early symptom recognition and comprehensive staging are vital for managing renal cell carcinoma.