J Korean Med Sci.  2024 Jan;39(3):e11. 10.3346/jkms.2024.39.e11.

Retrospective Multicenter Analysis of Prognostic Risk Factors for One Year Recurrence in Patient With Renal Cell Carcinoma After Partial or Radical Nephrectomy: Results of Korean Renal Cancer Study Group (KRoCS) Database

• Choi C
• Kang M
• Seo SI
• Suh J
• Song C
• Chung J
• Kim SH
• Park JY
• Hwang EC
• Jeong CW
• Kwak C
• Kim JK
• Hong SH

• KMID: 2551173
• DOI: http://doi.org/10.3346/jkms.2024.39.e11

Abstract

Background
We sought to identify prognostic risk factors for one year recurrence in patient with renal cell carcinoma (RCC) after partial or radical nephrectomy.
Methods
We performed a retrospective study of 1,269 patients with RCC after partial or radical nephrectomy and diagnosed recurrence using Korean Renal Cancer Study Group (KRoCS) database between January 1991 and March 2017. Recurrence-free survival (RFS), and overall survival (OS) were calculated using the Kaplan–Meier method and multivariate Cox regression analysis were performed to evaluate independent prognostic factors for recurrence.
Results
The median patient age was 56 years and median follow-up period was 67 months. Multivariable analysis demonstrated BMI greater than or equal to 23 and less than 30 (vs. BMI less than 23, hazard ratio [HR]: 0.707, P = 0.020) reduced recurrence one year postoperatively. Eastern Cooperative Oncology Group performance status (ECOG PS) greater than or equal to 1 (vs. ECOG PS 0, HR: 1.548, P = 0.007), high pathological T stage (pT2 vs.pT1, HR: 2.622, P < 0.001; pT3 vs. pT1, HR: 4.256, P < 0.001; pT4 vs. pT1, HR: 4.558, P < 0.001), and tumor necrosis (vs. no tumor necrosis, HR: 2.822, P < 0.001) were independent predictive factors for early recurrence within one year in patients with RCC. Statistically significant differences on RFS and OS were found among pathological T stages (pT2 vs. pT1; pT3 vs. pT1; pT4 vs. pT1, all P < 0.001).
Conclusion
This large multicenter study demonstrated ECOG PS greater than or equal to 1, high pathological T stage, tumor necrosis and BMI less than 23 were significant prognostic risk factors of early recurrence within one year in patients with RCC who underwent nephrectomy.

Keyword

Renal Cell Carcinoma; Early Metastasis; Prognosis; Risk Factor; Recurrence; Survival

Figure

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  Fig. 1 Kaplan-Meier curve for (A) disease-free survival and (B) overall survival of entire cohort.

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  Fig. 2 Kaplan-Meier curve for (A) recurrence-free survival and (B) overall survival among four pathological T stages.

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