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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 | Predictive factors for recurrence after complete metastasectomy in patients with metastatic renal cell carcinoma in the targeted therapy era. |
| 掲載誌名 | 正式名：Urologic oncology 略 称：Urol Oncol ISSNコード：18732496/10781439 |
| 掲載区分 | 国外 |
| 巻・号・頁 | 38(5),pp.515-520 |
| 著者・共著者 | TAKAGI Toshio†*, FUKUDA Hironori, ISHIHARA Hiroki, YOSHIDA Kazuhiko, KONDO Tsunenori, KOBAYASHI Hirohito, IIZUKA Junpei, OKUMI Masayoshi, ISHIDA Hideki, OMAE Kenji, TANABE Kazunari |
| 発行年月 | 2020/05 |
| 概要 | OBJECTIVES:Complete metastasectomy is expected to improve the survival of patients with metastatic renal cell carcinoma (mRCC). However, many patients develop re-recurrence, despite achieving complete remission with surgery. We examined recurrence-free survival (RFS) and analyzed predictive factors for recurrence after complete metastasectomy.METHODS:Fifty-one patients with mRCC who underwent complete metastasectomy between 2008 and 2018 were included in this study. Multivariate Cox regression analyses were performed to identify the prognostic factors for RFS.RESULTS:Of 51 patients, 6 (12%) had multiple metastatic sites and 45 (88%) had solitary metastasis. The pathological subtype was clear cell in 42 (82%), papillary in 8 (17%), and other subtype in 1 (2%) patient. Sarcomatoid features were found in 2 (4%) patients. The Memorial Sloan Kettering Cancer Center risk category was favorable in 43%, intermediate in 53%, and poor in 4% of patients. The median duration from nephrectomy to metastasectomy was 32 months. Of the total cohort, 39 patients (74%) developed recurrence after complete metastasectomy. The median RFS was 22 months, and the 2- and 5-year RFS rates were 45% and 25%, respectively. Multivariate Cox regression revealed that ≥2 metastatic sites (vs. 1 site; HR = 4.52; P = 0.024) and sarcomatoid features (HR = 11.5; P = 0.0171) were independent predictive factors for recurrence. The 2- and 5-year cancer-specific survival rates were 98% and 82%, respectively.CONCLUSION:The number of metastatic sites and sarcomatoid features were associated with recurrence after complete metastasectomy, which suggests that careful observation is required for such patients, even after achieving complete remission with metastasectomy. |
| DOI | 10.1016/j.urolonc.2020.02.003 |
| PMID | 32146128 |