高级检索
当前位置: 首页 > 详情页

Prognostic Significance of Grade Discrepancy Between Primary Tumor and Venous Thrombus in Nonmetastatic Clear-cell Renal Cell Carcinoma: Analysis of the REMEMBER Registry and Implications for Adjuvant Therapy

| 导出 | |

文献详情

资源类型:
WOS体系:
Pubmed体系:

收录情况: ◇ SCIE

作者:
单位: [a]Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China [b]European Association of Urology Young Academic Urologists RenalCancer Working Group, Arnhem, The Netherlands [c]Department of Pathology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing,China [d]Department of Health Statistics, Naval Medical University, Shanghai, China [e]Department of Urology, Jinling Hospital, Jinling School of ClinicalMedicine, Nanjing Medical University, Nanjing, China [f]Department of Urology, Qilu Hospital, Shandong University, Jinan, China [g]Unit of Urological RoboticSurgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy [h]Department of Experimental and Clinical Medicine, University ofFlorence, Florence, Italy [i]Department of Urology, Hospital Clinico San Carlos, Madrid, Spain [j]Department of Urology, Rush University Medical Center, Chicago,IL, USA [k]Department of Urology, GRC No. 5, Predictive ONCO-URO, Hospital Pitié-Salpêtrière, AP-HP, Sorbonne University, Paris, France [l]Department ofUrology, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA [m]Department of Urology, Icahn School of Medicine at Mount Sinai, NewYork, NY, USA [n]Division of Urology, Department of Oncology, School of Medicine, San Luigi Hospital, University of Turin, Orbassano, Italy [o]Department ofUrology, University of Rennes, Rennes, France [p]Department of Urologic Sciences, The University of British Columbia, Vancouver, British Columbia, Canada [q]Department of Urology.Hospital Universitario La Ribera.Valencia, Spain [r]Departments of Urology and Experimental and Clinical Medicine, University ofFlorence, Florence, Italy [s]Institute of Urology, University of Southern California, Los Angeles, CA, USA [t]Department of Urology, University of Texas Southwestern Medical Center, Dallas, TX, USA [u]Urology Unit, San Carlo di Nancy Hospital, Rome, Italy [v]Department of Diagnostic and Public Health,University of Verona, Verona, Italy [w]Department of Emergency and Organ Transplantation-Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy [x]Department of Urology, Weill Cornell Medicine/New York-Presbyterian, New York, NY, USA [y]Medical Oncology Unit, Comprehensive CancerCenter, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy [z]Department of Urology, Fundació Puigvert, Autonoma University of Barcelona,Barcelona, Spain [aa]Division of Urologic Oncology, Department of Urology, Istanbul University Faculty of Medicine, Istanbul, Turkey [bb]Department ofOncology, IRCCS Ospedale San Raffaele, Milan, Italy [cc]Department of Medical, Oral and Biotechnological Sciences, Urology Unit, University G. d’Annunzio,Chieti, Italy [dd]Department of Urology, Radboud University Medical Center, Nijmegen, The Netherlands [ee]Division of Urology, Department of TranslationalMedicine, University of Eastern Piedmont, Maggiore della Carità Hospital, Novara, Italy [ff]Urology Clinic, Department of Surgical, Oncological, and OralSciences, University of Palermo, Palermo, Italy [gg]Department of Urology, Pederzoli Hospital, Peschiera del Garda, Italy [hh]Department of Urology, UniversityHospitals Leuven, Leuven, Belgium [ii]Division of Surgery and Interventional Science, University College London, London, UK [jj]Department of Neurosciences,Reproductive Sciences and Odontostomatology, University of Naples Federico II, Naples, Italy [kk]Department of Urology, Jinling Hospital, Clinical School ofNanjing University Medical College, Nanjing, China [ll]Department of Urology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai,China [mm]Department of Pathology, Changhai Hospital, Naval Medical University, Shanghai, China [nn]Department of Urology, Daping Hospital, Army MedicalUniversity, Chongqing, China [oo]Department of Pathology, Qilu Hospital, Shandong University, Jinan, China [pp]Department of Pathology,Tongji Hospital,TongjiMedical College,Huazhong University of Science and Technology,Wuhan,China [qq]Department of Urology,Tongji Hospital,Tongji Medical College,HuazhongUniversity of Science and Technology,Wuhan,China [rr]Department of Urology, Southwest Hospital, Army Medical University, Chongqing, China [ss]Departmentof Pathology, Drum Tower Hospital, Clinical School of Nanjing University Medical College, Nanjing, China [tt]Department of Urology, Drum Tower Hospital,Clinical School of Nanjing University Medical College, Nanjing, China [uu]Department of Pathology, Zhongda Hospital, Southeast University, Nanjing, China [vv]Department of Urology, Zhongda Hospital, Southeast University, Nanjing, China [ww]Department of Urology, Xiangya Hospital, Central South University,Changsha, China [xx]Department of Urology, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China [yy]Department of Urology,Changzheng Hospital, Naval Medical University, Shanghai, China [zz]Department of Urology, Huashan Hospital, Fudan University, Shanghai, China [aaa]Department of Urology, Affiliated Yantai Yuhuangding Hospital, Qingdao University, Yantai, China [bbb]Department of Pathology, Affiliated YantaiYuhuangding Hospital, Qingdao University, Yantai, China [ccc]Department of Urology, The Second Affiliated Hospital of Dalian Medical University, Dalian,China [ddd]Department of Urology, The First Affiliated Hospital of Anhui Medical University, Hefei, China [eee]Department of Urology, The First Affiliated Hospitalof Nanchang University, Nanchang, China [fff]Department of Urology, Urology Research Institute, The First Affiliated Hospital, Fujian Medical University, Fuzhou,China [ggg]Department of Urology, Anhui Provincial Hospital/The First Hospital of the University of Science and Technology of China, Hefei, China [hhh]Department of Urology, The First Affiliated Hospital of Shandong First Medical University, Jinan, China [iii]Department of Urology, Shanghai East Hospital,Tongji University, Shanghai, China [jjj]Department of Pathology, Shanghai East Hospital, Tongji University, Shanghai, China [kkk]Center for Genomic andPersonalized Medicine, Guangxi Medical University, Nanning, China [lll]Department of Urology, The First Affiliated Hospital of Guangxi Medical University,Nanning, China [mmm]Department of Urology, Xijing Hospital, Fourth Military Medical University, Xi’an, China [nnn]Department of Pathology, Xijing Hospital,Fourth Military Medical University, Xi’an, China [ooo]Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China [ppp]Departmentof Medical Oncology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China
出处:
ISSN:

关键词: Renal cell carcinoma Venous tumor thrombus Tumor grade Progression Upgrading Downgrading Model Prognosis Adjuvant therapy

摘要:
Further stratification of the risk of recurrence of clear-cell renal cell carcinoma (ccRCC) with venous tumor thrombus (VTT) will facilitate selection of candidates for adjuvant therapy.To assess the impact of tumor grade discrepancy (GD) between the primary tumor (PT) and VTT in nonmetastatic ccRCC on disease-free survival (DFS), overall survival (OS), and cancer-specific survival (CSS).This was a retrospective analysis of a multi-institutional nationwide data set for patients with pT3N0M0 ccRCC who underwent radical nephrectomy and thrombectomy.Pathology slides were centrally reviewed. GD, a bidirectional variable (upgrading or downgrading), was numerically defined as the VTT grade minus the PT grade. Multivariable models were built to predict DFS, OS, and CSS.We analyzed data for 604 patients with median follow-up of 42 mo (excluding events). Tumor GD between VTT and PT was observed for 47% (285/604) of the patients and was an independent risk factor with incremental value in predicting the outcomes of interest (all p < 0.05). Incorporation of tumor GD significantly improved the performance of the ECOG-ACRIN 2805 (ASSURE) model. A GD-based model (PT grade, GD, pT stage, PT sarcomatoid features, fat invasion, and VTT consistency) had a c index of 0.72 for DFS. The hazard ratios were 8.0 for GD = +2 (p < 0.001), 1.9 for GD = +1 (p < 0.001), 0.57 for GD = -1 (p = 0.001), and 0.22 for GD = -2 (p = 0.003) versus GD = 0 as the reference. According to model-converted risk scores, DFS, OS, and CSS significantly differed between subgroups with low, intermediate, and high risk (all p < 0.001).Routine reporting of VTT upgrading or downgrading in relation to the PT and use of our GD-based nomograms can facilitate more informed treatment decisions by tailoring strategies to an individual patient's risk of progression.We developed a tool to improve patient counseling and guide decision-making on other therapies in addition to surgery for patients with the clear-cell type of kidney cancer and tumor invasion of a vein.Copyright © 2023 European Association of Urology. Published by Elsevier B.V. All rights reserved.

基金:
语种:
被引次数:
WOS:
PubmedID:
中科院(CAS)分区:
出版当年[2023]版:
大类 | 1 区 医学
小类 | 1 区 肿瘤学 1 区 泌尿学与肾脏学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 泌尿学与肾脏学 2 区 肿瘤学
JCR分区:
出版当年[2022]版:
Q1 ONCOLOGY Q1 UROLOGY & NEPHROLOGY
最新[2023]版:
Q1 ONCOLOGY Q1 UROLOGY & NEPHROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2022版] 出版当年五年平均 出版前一年[2021版] 出版后一年[2023版]

第一作者:
第一作者单位: [a]Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China [b]European Association of Urology Young Academic Urologists RenalCancer Working Group, Arnhem, The Netherlands [y]Medical Oncology Unit, Comprehensive CancerCenter, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy [*1]Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, China. Jinling Hospital, Clinical School of Nanjing University Medical College, 305 East Zhongshan Road, Nanjing 210000, China.
共同第一作者:
通讯作者:
通讯机构: [a]Department of Urology, Changhai Hospital, Naval Medical University, Shanghai, China [b]European Association of Urology Young Academic Urologists RenalCancer Working Group, Arnhem, The Netherlands [y]Medical Oncology Unit, Comprehensive CancerCenter, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy [kk]Department of Urology, Jinling Hospital, Clinical School ofNanjing University Medical College, Nanjing, China [ooo]Department of Radiology, Changhai Hospital, Naval Medical University, Shanghai, China [ppp]Departmentof Medical Oncology, Jinling Hospital, Clinical School of Nanjing University Medical College, Nanjing, China [*1]Changhai Hospital, Naval Medical University, 168 Changhai Road, Shanghai 200433, China. Jinling Hospital, Clinical School of Nanjing University Medical College, 305 East Zhongshan Road, Nanjing 210000, China.
推荐引用方式(GB/T 7714):
APA:
MLA:

资源点击量:590 今日访问量:1 总访问量:442 更新日期:2025-06-01 建议使用谷歌、火狐浏览器 常见问题

版权所有:重庆聚合科技有限公司 渝ICP备12007440号-3 地址:重庆市两江新区泰山大道西段8号坤恩国际商务中心16层(401121)