patientoutcomeandprognosticfactorsofrenalcellcarcinomainclinicalstaget1-3n1-2m0:asingle-institutionanalysis

abstract:objectivetoreportourdataofpatientswithclinicalstaget1-3n1-2m0renalcellcarcinoma(rcc)andexplorethebiologicalbehaviorofthismalignancy.methodsatotalof531patientswithnodistantmetastaticrccunderwentopenradicalnephrectomyatourinstitutionbetween1988and2008,amongwhom42patientswithhistologicalnodalmetastaseshadsuccessfulsurgicaltumorresection.theclinicaldataandoutcomesofthe42patientswereanalyzed.resultsofthose42patients,19.0%hadt1,21.4%hadt2,and59.5%hadt3stagetumors;42.9%hadn1and57.1%hadn2stagetumors.tumorrecurredin30(71.4%)patientsafterthesurgery,anddeathoccurredin26(61.9%)casesatthelastfollow-up;amongtherecurrentcases,83.3%(25/30)hadmultiplemetastasesattheinitialrecurrence.themediancancer-specificsurvival(css)anddisease-freesurvival(dfs)was23and11monthsinthesecases,respectively.multivariateanalysisdemonstratedthatfuhrmangrade(p=0.005),nstage(p=0.014)andtstage(p=0.037)weretheindependentpredictorsofcss;easterncooperativeoncologygroup(ecog)performancestatus(ps)(p=0.002),tumorsize(p=0.007),fuhrmangrade(p=0.009)andnstage(p=0.019)weretheindependentpredictorsofdfs.conclusionpatientswitht1-3n1-2m0rcchavepoorprognosis.nstageisanindependentpredictorofbothcssanddfs,suggestingthatextendedlymphnodedissectionshouldbeperformedwhensuspiciousenlargednodaldiseaseisfoundduringsurgery.