Risk factors for postoperative recurrence and metastasis and the impact of surgical approaches on the prognosis of T1 stage Ⅲ/Ⅳ clear cell renal cell carcinoma
10.12483/j.issn.1009-8291.2026.01.003
- VernacularTitle:T1期Ⅲ/Ⅳ级肾透明细胞癌术后复发转移的危险因素分析及手术方式对预后的影响
- Author:
Jianbo JI
1
;
Haonan CHEN
2
;
Tiantian YUAN
3
;
Zhaokui QU
3
;
Guoxin SONG
4
;
Meiling BAO
4
;
Xiaodong LIANG
3
;
Bo JIANG
3
;
Yiyang WANG
3
;
Hao JI
2
;
Pengchao LI
5
Author Information
1. Department of Urology, The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029; Department of Urology, Yancheng Third People's Hospital, Yancheng 224001
2. Department of Urology, The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029
3. Department of Urology, Yancheng Third People's Hospital, Yancheng 224001
4. Department of Pathology, The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029
5. Department of Urology, The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital), Nanjing 210029; Department of Urology, Jiangsu Province(Suqian)Hospital(Suqian First Hospital), Suqian 223800, China
- Publication Type:Journal Article
- Keywords:
clear cell renal cell carcinoma;
partial nephrectomy;
radical nephrectomy;
disease-free survival;
overall survival
- From:
Journal of Modern Urology
2026;31(1):12-16
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the risk factors for postoperative recurrence and metastasis in patients with T1 stageⅢ/Ⅳ clear cell renal cell carcinoma(ccRCC), and to analyze the influence of surgical methods on prognosis, so as to provide prognostic evaluation and treatment guidance for clinical practice. Methods A retrospective analysis was conducted on 398 patients diagnosed with T1 stage Ⅲ/Ⅳ ccRCC who underwent either partial nephrectomy(PN)or radical nephrectomy(RN)at Jiangsu Province Hospital during Jan. 2008 and Sep. 2022. The patients were divided into recurrence group(n=49)and non-recurrence group(n=349)according to whether the tumor recurred during the follow-up period. The general, clinical data and prognosis were compared between the two groups. Univariate and multivariate Cox regression analyses were used to explore the factors influencing disease-free survival(DFS)and overall survival(OS)after surgery. Subgroup analysis using Kaplan-Meier curves was performed for T1a and T1b patients. Results During the median follow-up of 67(42, 98)months, the recurrence group was characterized by older age, larger tumor diameter, higher proportion of T1b stage, and more complex tumor anatomy. Univariate and multivariate Cox regression analyses showed that age ≥55 years and R.E.N.A.L. score ≥7 were independent risk factors for poorer DFS and OS(P＜0.05). Subgroup analysis revealed that PN or RN did not significantly affect DFS or OS in T1a patients and OS in T1b patients, while RN significantly improved DFS in T1b patients(P＜0.05). Conclusion Age ≥55 years and R.E.N.A.L. score ≥7 are independent risk factors for poor DFS and OS in highgrade T1 ccRCC patients. For T1b patients, RN may improve DFS.
