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Title   전이 신세포암의 예후 ( Prognosis of Methastatic Renal Cell Carcinoma )
Publicationinfo   1992 Jan; 024(01): 160-168.
Key_word   Metastatic renal cell carcinoma, Prognosis
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Abstract   We analysed retrospectively 97 patients with metastatic renal cell carcinoma who were man- aged at Seoul National University Hospital during the last 12 years. Sixty nine of the patients had metastatic disease at the initial diagnosis, and 2B had metastasis after nephrectomy. Sixty three patients were men and 34 women. The mean age was 55 years. Ninety one patients were followed to the end of their lives. Among 69 patients with metastatic disease at the initial diagnosis, weight loss was found in 38 patients(55.1%) and gross hemataria was found in 33(47.8%). Twenty one patients(30.4%) had metastatic symptoms. Laboratory findings showed increased ESR(more than 20) in 57 patients(82.6%), anemia(hemoglobin less than 10.0) in 43(62.3%), elevat- ed alkaline phosphatase in 33(47.8%), elevated SGOT/SGPT in 2l(30.4%), hypercalcemia(more than l0.5) in 15(21.7%). Lung was the most common metastatic site, 35 patients(50.7%) had pul- monary metastasis, and bone, liver, brain and other organs in the order. Overall one year, 2 year and 5 year survival rate was 50%, 9.8% and 0% respectively, and the mean survival of the patients was 14.5 months. Among 28 patients who had metastatic lesions after nephrectomy, 19 patients(68%) had metastasis within one year after nephrectomty. The age, sex, clinical features, laboratory findings and metastatic locations were similar to the metastatic disease at the initial diagnosis. All the patients died within 2 years after metastasis, with the mean survival of 12.B months. Prognostic significances of various factors such as age, sex, gross hematuria, palpable mass, weight loss, metastatic symptoms, anemia, LFT, serum calcium level, alkaline phosphatase level, ESR, multiplicity of the metastasis and multiorgan metastasis, treatment modality were assessed. In patients with initial metastatic disease, weight loss, anemia, elevated serum alkaline phosphatase and multiple metastasis had the prognostic significance in univariate ana lysis(p<0.05), and weight loss and anemia was significant statistically in multivariate analysis (p<0.05), and it was the same in patients with metastasis after nephrectomy. Taking these prognastic factors into consideration, the survival pattern of the individual patients can be assessed, and will be benificial in planning the adequate treatment modalities.
저 자   박원희(Won Hee Park),김현회(Hyeon Hoe Kim),이은식(Eun Sik Lee),이종욱(Chong Wook Lee)