Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 3 de 3
Filter
Add filters








Language
Year range
1.
Journal of Modern Urology ; (12): 216-221, 2023.
Article in Chinese | WPRIM | ID: wpr-1006118

ABSTRACT

【Objective】 To investigate the predictive factors of clinical T1 (cT1) stage renal cell carcinoma (RCC) escalation to T3a (pT3a), hoping to identify high-risk patients with occult pT3a features. 【Methods】 A total of 666 patients with cT1 RCC who underwent radical or partial nephrectomy were involved and divided into upstaging group and non-upstaging group. The independent predictive factors of cT1 to pT3a stage were determined with univariate and multivariate logistic regression analyses. A model was established. The area under the receiver operator characteristic (ROC) curve (AUC) and calibration plot were used to assess the predictive model’s discrimination and calibration. 【Results】 The upgrading rate was 11.4% (n=76). The RENAL score, neutrophil-to-lymphocyte ratio (NLR), prognosis nutrition index (PNI) and Cystatin C (Cys C) were correlated to pT3a upgrading. Our model exhibited good discrimination (AUC=0.726, 95%CI:0.662-0.791) and decent calibration. In the internal validation, the high C-index value of 0.717 was still attainable. 【Conclusions】 RENAL score, NLR, PNI, and Cys C can be used to predict the risk of postoperative pT3a stage escalation in patients with cT1 stage renal cancer. Urologists can complete risk stratification and treatment based on these indicators.

2.
Chinese Journal of Urology ; (12): 742-746, 2019.
Article in Chinese | WPRIM | ID: wpr-791678

ABSTRACT

Objective To evaluate the risk factors of postoperative upgrade to pT3a of cT1 renal cell carcinoma,and to establish a nomogram prediction model to improve the ability of predicting locally advanced renal cell carcinoma and provide a reference for clinical surgical decision-making.Methods Clinical data of 1 376 patients with cT1 (diameter ≤ 7 cm) renal tumor hospitalized for surgery from January 2010 to December 2016 were retrospectively analyzed.There were 979 males and 397 females,with the mean age of (57.65 ± 10.92) years.The mean body mass index (BMI) was (25.47 ± 3.27) kg/m2 and the average tumor size was (4.02 ±1.52) cm.There were 711 tumors on the left and 665 on the right.There were 363 cases with clinical symptoms,567 patients with smoking history,732 cases with history of chronic disease.There were 289 cases with tumor necrosis,636 cases with tumor protrusion,822 cases with irregular tumor,and 738 cases with renal sinus compression.Partial nephrectomy and radical nephrectomy were performed in 396 cases and 980 cases respectively.Mann-whitney U test and chi-square test were used for univariate analysis,logistic regression analysis was used for multivariate analysis to analyze the predictors of upgrading,R software was used to construct the nomogram predictive model,C-index was used to evaluate the model discrimination,and calibration curve method was used to evaluate the consistency of the model.Results Postoperative pathology of total 1 376 cases showed that there were 1 195 cases of clear cell carcinoma of kidney,48 cases of papillary cell carcinoma,57 cases of chromophobe cell carcinoma,and 76 cases of other types.Among the 1 376 patients with cT1 renal tumor,75 patients were upgraded to pT3a,accounting for 5.5% of all patients.Univariate analysis showed that the patients who upgraded to pT3a were older [(63.08 ± 10.17) years old and (57.34 ± 10.88) years old],and the tumor length and diameter were larger [(5.24 ± 1.35) cm and (3.95 ± 1.51) cm].Patients with clinical symptoms [46.7% (35/75) vs.25.2% (328/1 301)],patients with CT indication of tumor necrosis [40.0% (30/25 975) vs.19.9% (259/1 301)],patients with irregular tumor contour [73.3% (55/76 775) vs.59.0% (767/1 301)],and patients with radical nephrectomy were higher [(92.1% (70/91 075) vs.70% (910/ 1 301)].All the differences were statistically significant (P <0.01).Multivariate analysis showed that the independent predictors of upgrading were age (OR =1.046,P <0.001),larger tumor (OR =1.504,P <0.001),clinically symptom (OR =2.153,P =0.004),irregular tumor profile (OR =2.466,P =0.002),and tumor necrosis on CT (OR =2.588,P < 0.001).The C-index was 0.808,the calibration curve of forecasting curve with the standard curve fit was good,and the prediction of renal cancer are better in predict consistency.Conclusions Based on the five preoperative predictors,including age,tumor size,clinical presence or absence of symptoms,tumor profile,and whether or not the tumor necrosis indicated by CT,this study developed a nomogram of cT1 renal cancer upgrade to pT3a.This nomogram has a good statistical significance,and this model can provide prognosis consultation for patients and provide reference for doctors to make decisions before treatment.

3.
Chinese Journal of Urology ; (12): 742-746, 2019.
Article in Chinese | WPRIM | ID: wpr-796746

ABSTRACT

Objective@#To evaluate the risk factors of postoperative upgrade to pT3a of cT1 renal cell carcinoma, and to establish a nomogram prediction model to improve the ability of predicting locally advanced renal cell carcinoma and provide a reference for clinical surgical decision-making.@*Methods@#Clinical data of 1 376 patients with cT1 (diameter ≤ 7 cm) renal tumor hospitalized for surgery from January 2010 to December 2016 were retrospectively analyzed. There were 979 males and 397 females, with the mean age of (57.65±10.92) years. The mean body mass index (BMI) was (25.47±3.27) kg/m2 and the average tumor size was (4.02±1.52) cm. There were 711 tumors on the left and 665 on the right. There were 363 cases with clinical symptoms, 567 patients with smoking history , 732 cases with history of chronic disease. There were 289 cases with tumor necrosis, 636 cases with tumor protrusion, 822 cases with irregular tumor , and 738 cases with renal sinus compression. Partial nephrectomy and radical nephrectomy were performed in 396 cases and 980 cases respectively. Mann-whitney U test and chi-square test were used for univariate analysis, logistic regression analysis was used for multivariate analysis to analyze the predictors of upgrading, R software was used to construct the nomogram predictive model, C-index was used to evaluate the model discrimination, and calibration curve method was used to evaluate the consistency of the model.@*Results@#Postoperative pathology of total 1 376 cases showed that there were 1 195 cases of clear cell carcinoma of kidney, 48 cases of papillary cell carcinoma, 57 cases of chromophobe cell carcinoma, and 76 cases of other types. Among the 1 376 patients with cT1 renal tumor, 75 patients were upgraded to pT3a, accounting for 5.5% of all patients. Univariate analysis showed that the patients who upgraded to pT3a were older [(63.08±10.17) years old and (57.34±10.88) years old], and the tumor length and diameter were larger [(5.24±1.35) cm and (3.95±1.51) cm]. Patients with clinical symptoms [46.7% (35/75) vs. 25.2%(328/1 301)], patients with CT indication of tumor necrosis [40.0%(30/25 975) vs. 19.9% (259/1 301)], patients with irregular tumor contour [73.3%(55/76 775) vs. 59.0%(767/1 301)], and patients with radical nephrectomy were higher [(92.1% (70/91 075) vs. 70%(910/1 301)]. All the differences were statistically significant (P<0.01). Multivariate analysis showed that the independent predictors of upgrading were age (OR=1.046, P<0.001), larger tumor (OR=1.504, P<0.001), clinically symptom (OR=2.153, P=0.004), irregular tumor profile (OR=2.466, P=0.002), and tumor necrosis on CT (OR=2.588, P<0.001). The C-index was 0.808, the calibration curve of forecasting curve with the standard curve fit was good, and the prediction of renal cancer are better in predict consistency.@*Conclusions@#Based on the five preoperative predictors, including age, tumor size, clinical presence or absence of symptoms, tumor profile, and whether or not the tumor necrosis indicated by CT, this study developed a nomogram of cT1 renal cancer upgrade to pT3a. This nomogram has a good statistical significance, and this model can provide prognosis consultation for patients and provide reference for doctors to make decisions before treatment.

SELECTION OF CITATIONS
SEARCH DETAIL