The Study Of Immunotherapy After Nephrectomy For Renal Cell Carcinoma

ObjectivesDiscuss the clinical significance of adjuvant immunotherapy. By retrospective study, observe the role of adjuvant immunotherapy to prevent the long-term metastasis and recurrence of patients with renal cell carcinoma. Analysis the influence on the prognosis of adjuvant immunotherapy of patients after nephrectomy.Methods We retrospectively studied298patients with renal cell carcinoma who underwent radical nephrectomy from January2000to December2005at Tianjin Medical University Cancer Hospital. Univariate and Multivariate analysis were used to analyze some clinical factors relevant to the prognosis of renal cell carcinoma such as sex, age, side of tumor, pathological type, tumor size, T stage, with or without adjuvant immunotherapy.Results1. Five-year progression-free survival of patients who received IFNa-2a, LAK cell therapy and no treatment after radical nephrectomy was as follow:90.0%,83.5%and68.1%.2. Five-year survival of patients who received IFNa-2a, LAK cell therapy and no treatment after radical nephrectomy was as follow:91.4%,89.9%and76.5%.3. Univariate analysis showed that three factors have significant effect on five-year progression-free survival for patients with renal cell carcinoma such as tumor size (P<0.001), T stage (P<0.001), with or without adjuvant immunotherapy (P<0.001).4. Univariate analysis showed that four factors have significant effect on five-year survival for patients with renal cell carcinoma such as pathological type (P=0.019), tumor size (P=0.001), T stage (P<0.001), with or without adjuvant immunotherapy (P=0.003).5. Univariate analysis showed that there was no significant difference between IFNa-2a (P=0.240) and LAK cell therapy (P=0.728) about the influence on the five-year progression-free survival and the five-year survival.6. A multivariable Cox regression model revealed two factors are relevant to five-year survival for patients with renal cell carcinoma. They are T stage (P=0.006), with or without adjuvant immunotherapy (P=0.015).7. A multivariable Cox regression model revealed only one factor is relevant to five-year survival for patients with renal cell carcinoma. It is with or without adjuvant immunotherapy (P=0.021).Conclusions1. Gender, age and side of tumor have no significant effect on five-year progression-free survival and five-year survival and should not be as an independent prognostic factor for renal cell carcinoma.2. Pathological type was associated with five-year survival. But a multivariable Cox regression model revealed that it is not an independent predictor on renal cell carcinoma.3. Tumor size and T stage were associated with five-year progression-free survival and five-year survival and T stage was an independent predictor on renal cell carcinoma.4. With or without adjuvant immunotherapy has significant effect on five-year progression-free survival and five-year survival and should be as an independent prognostic factor for renal cell carcinoma.5. Adjuvant immunotherapy after radical nephrectomy could reduce the risk of recurrence and metastasis and prolong survival time.6. There is no significant difference between the two type immunotherapy and they are all able to improve the prognosis of patients with renal cell carcinoma.