ナガシマ ヨウジ   Nagashima Youji
  長嶋 洋治
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授・基幹分野長
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