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コバヤシ ヒロヒト
Kobayashi Hirohito
小林 博人 所属 医学部 医学科（附属足立医療センター） 職種 准教授 |
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| 論文種別 | 原著 |
| 言語種別 | 英語 |
| 査読の有無 | 査読あり |
| 表題 | Outcome of advanced renal cell carcinoma arising in end-stage renal disease: comparison with sporadic renal cell carcinoma. |
| 掲載誌名 | 正式名：Clinical and experimental nephrology 略 称：Clin Exp Nephrol ISSNコード：13421751/14377799 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 25(6),pp.674-682 |
| 著者・共著者 | ISHIHARA Hiroki†*, FUKUDA Hironori, TACHIBANA Hidekazu, YOSHIDA Kazuhiko, KOBAYASHI Hirohito, TAKAGI Toshio, IIZUKA Junpei, ISHIDA Hideki, NAGASHIMA Yoji, KONDO Tsunenori, TANABE Kazunari |
| 発行年月 | 2021/06 |
| 概要 | BACKGROUND:The data regarding oncological outcome in advanced renal cell carcinoma (RCC) arising in end-stage renal disease (ESRD) are limited.METHODS:Patients diagnosed with advanced RCC on maintenance dialysis therapy (ESRD-RCC) and treated with tyrosine kinase inhibitors (TKIs) were retrospectively evaluated. Progression-free survival (PFS), overall survival (OS), and objective response rate (ORR) after initiation of first-line TKI therapy in ESRD-RCC patients were compared to those in RCC arising in the general population (sporadic RCC).RESULTS:A total of 36 and 240 patients were diagnosed with advanced ESRD-RCC and sporadic RCC, respectively. PFS and OS were significantly shorter in patients with ESRD-RCC than in those with sporadic RCC (p = 0.0004 and p = 0.0045). After adjusting for histopathological type, MSKCC risk and liver metastasis status, ESRD status (ESRD-RCC vs. sporadic RCC) was not an independent risk factor for PFS or OS (both, p > 0.05). The ORR tended to be lower in patients with ESRD-RCC than in those with sporadic RCC (11% vs. 28%, p = 0.0833). In 34 patients with ESRD-RCC treated with sorafenib, longer duration of dialysis was an independent prognostic factor for shorter OS (hazard ratio 3.21, p = 0.0370).CONCLUSIONS:Outcome of advanced ESRD-RCC was poorer than that of sporadic RCC, but this finding was affected by other prognostic factors. Nevertheless, the study suggested that advanced ESRD-RCC was not an indolent disease. Additionally, patients with a longer duration of dialysis therapy might require careful monitoring. |
| DOI | 10.1007/s10157-021-02038-3 |
| PMID | 33641007 |