| Objective:To evaluate the clinicopathological features and prognostic factors of nonmetastatic renal cell carcinoma.Methods:A total of 183 patients with renal cell carcinoma who were surgically treated in the urology department of General Hospital of Northern Theater Command from January 2013 to January 2018 and confirmed by the pathology department were retrospectively studied.The clinical and pathological characteristics of non-metastatic renal cancer patients were analyzed.Follow-up of these patients to understand their postoperative recovery,survival status,and tumor recurrence and metastasis.Excel database was formed according to the collected information.Based on the receiver operating characteristic curve,the optimal threshold of NILR,PLR,LMR,and AGR were obtained,and the indicators were divided into high-level group and low-level group according to the optimal threshold of the indicators.SPSS 24.0 and MedCalc 19.0.4 statistical software were used for statistical analysis of data;Kaplan-Meier method was used for univariate analysis,log-rank test was used to compare differences between groups,and statistically significant single factors were included in multivariate analysis,and COX proportional hazards regression model was used for multivariate analysis and the survival curves of each factor were plotted.Results were considered significant at P <0.05.Test level ? = 0.05.Results:By the end of the study,168 cases were followed up with a follow-up rate of 91.8%.The range of follow-up time was 2 to 78 months,with an average follow-up time of 45.04±16.73 months and a median follow-up time of 47 months.1-year,3-year,and 5-year Overall Survival(OS)rates were 97.6%,94.0%,and 89.9% respectively.There were 117 males and 51 females,with a male-to-female ratio of about 2.29: 1;aged 26-87 years,with an average age of 56.07 ± 10.87 years.Postoperative pathological T stage was 131 cases in pT1 stage,23 cases in pT2 stage,12 cases in pT3 stage,and 2 cases in pT4 stage;pathological subtype was clear cell carcinoma in154,papillary cell carcinoma in 9 and chromophobe renal carcinoma in 5;Fuhrman grade was grade I in 42,grade II in 102,grade III in 21,grade IV in 3;There was collective system invasion in 8 cases;There were 43 cases with clinical symptoms and 125 cases without symptoms;130 cases were found because of physical examination,38 cases were found because of hematuria,waist and abdomen pain,lumps,fatigue,weight loss,etc;The ECOG-PS score was 0 for 123 people,1 for 43 people,and 2 for 2 people.Using ROC curve to find the optimal threshold: NLR was 2.72,LMR was 3.33,PLR was 179,AGR was 1.38.Kaplan-Meier analysis revealed that NLR,PLR,LMR,AGR,age,pT stage,Fuhrman grade,ECOG-PS score,with clinical symptoms,and collective system invasion were associated with the overall survival of nonmetastatic renal cell carcinoma;COX multivariate analysis showed that NLR,AGR,LMR,Fuhrman grade,and ECOG-PS score were independent factors affecting the prognosis of non-metastatic renal cell carcinoma.Conclusions:Tumor stage and Fuhrman grade were independent prognostic factors for renal cell carcinoma,and NLR > 2.27,LMR < 3.33,AGR < 1.38 and high ECOGPS score were independent poor prognostic factors of non-metastatic renal cell carcinoma,while PLR was not an independent prognostic factor of non-metastatic renal cell carcinoma. |
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