Analysis Of Long-term Survival Rate And Prognosis Factors For Patients Treated With Radical Nephrectomy

Objective: Renal carcinoma is one of the most common malignant tumor inurinary system and the incidence is increasing in recent years. Radical nephrectomy isstill the gold standard for treatment of patients who are not suitable for nephron sparingsurgery. At present, there are short of effective predictor of prognosis for radicalnephrectomy. The main prognosis factors of survival for patients treated with radicalnephrectomy are studied by reviewing the case file record, pathological report and dataof follow-up.Methods:388cases of renal cell carcinoma treated with “Radical Nephrectomy”from Jan.2006to Dec.2012were follow-up. The survival rates were calculated byKapplan-Meier method. Cox regression model method was used to analyze therelationship between the influencing factors and the prognosis. The relevant factorsincluded age, sex, smoking history, marasmus, clinical symptoms(hematuria, flankpain), Tumor size, Lymph node metastasis, pathological classification(Fuhrman grade),clinical staging, postoperative therapy, etc.Results: The mean follow-up was46months and the median follow-up was50months (range,1-84months). The overall cancer specific survival rate of388patients at1,3,5year were94.35%,86.40%,77.75%, respectively. The estimated5-year rate was95.9%,89.1%,49.7%and25.0%for patients with Fuhrman grade of G1, G2, G3andG4, respectively. It was92.6%,81.9%,38.6%and19.0%for TNM staging of T1, T2,T3and T4, respectively. It was16.7%and83.0%for metastasis of lymph node andnone. It was41.6%and83.3%for thrombus enter into vena and not. It was26.3%and87.1%for distant metastasis and none. It was60.7%and83.3%for lower HB andnormal HB before operation. Kapplan-Meier method showed that the prognostic factorswere incidental occurrence, hematuria, TNM staging, Fuhrman grade, Lymph node metastasis, tumor thrombus, distant metastasis, PLT, ALP, HB, serum calcium. Coxregression model showed that the independent predictive factors were TNM staging（P＜0.001）, Fuhrman grade（P＜0.001）, Lymph node metastasis（P＜0.001）, tumorthrombus（P=0.015）, distant metastasis（P=0.002）, HB（P=0.049）.Conclusions: The survival rate of patients treated with radical nephrectomyreduced with the increase of TNM staging and Fuhrman grade, moreover, there arecertain correlation between prognosis and lymph node metastasis, tumor thrombus,distant metastasis, HB.