| Objective To explore the clinical features and prognostic factors of incidental renal cellcarcinomasMaterials and methods A total of 401 patiens of renal carcinoma from Afiliated Hospitalof Qingdao University were included in this study. Based on symptoms at diagnosis, patientswere statified into 3 groups,incidental tumors, tumors with local symptoms, tumors withsystemic symptoms, and analysed their clinical features. Chi square test was assessed thedifference of the three groups. Survival assessment was made with univariate andmultivariate analyses using the Kaplan-Meier method and Cox regression analysis, all datawere dealed with SPSS11.5.Results Of the patiens, 117 were the incidentals, local symptoms, 203; systemic symptoms,27. the classification correlated with tumor size, histologic subtypes, stage, grade, ECOGperformance status, symptom, venous thrombus and lymphatic metastasis (P＜0.01). Onunivariate analysis age, gender, sarcomatoid component, histologic subtypes, grade,symptoms, venous thrombus, tumor size, lymphatic metastasis, distant metastasis, TNMstage, ECOG performance status were significant prognostic factors (P＜0.01). Onmultivariate analysis age, sarcomatoid component,systemic symptoms, venous thrombus,lymphatic metastasis, distant metastasis, TNM stage remained independent prognosticfactors (P＜0.05).Conclusions It is possible to graduate symptoms for a prognostic purpose. The proposedsymptom score should be evaluated for its integration in prognostic algorithms. Theincidental tumors are of significantly smaller, lower stage, lower grade, less lymphaticmetastasis and higher survival rate than non-incidentals. However, the systemic symptomsare of worse survival and independent prognostic factors. We should select the proper way ofoperation and strategy of follow-up.
|
PDF Full Text Request