Résumé
Unusual sites of metastases are recognized in patients with renal cell carcinoma (RCC). However, the prognostic implications of these sites are not well understood. We used the Memorial Sloan-Kettering Cancer Center (MSKCC) risk classification for metastatic RCC to evaluate 912 consecutive patients with RCC managed at the Singapore General Hospital between 1990 and 2009. Among these patients, 301 had metastases either at diagnosis or during the course of illness. Nasal metastases, all arising from clear cell RCC, were identified histologically in 4 patients (1.3% of those with metastasis). All 4 patients were classified as MSKCC poor prognosis by current risk criteria. Nasal metastases were significantly associated with lung and bone metastases. The frequency of nasal metastases in patients with metastatic RCC is about 1%, occurring predominantly in patients with clear cell RCC. Nasal metastases are associated with poor prognosis as estimated by the MSKCC risk classification, with attendant implications for selection of targeted therapy, and are usually associated with multi-organ dissemination, including concurrent lung and bone involvement.
Sujets)
Femelle , Humains , Mâle , Adulte d'âge moyen , Antinéoplasiques , Utilisations thérapeutiques , Tumeurs osseuses , Néphrocarcinome , Imagerie diagnostique , Thérapeutique , Indoles , Utilisations thérapeutiques , Tumeurs du rein , Imagerie diagnostique , Anatomopathologie , Thérapeutique , Tumeurs du poumon , Néphrectomie , Tumeurs du nez , Anatomopathologie , Thérapeutique , Pyrroles , Utilisations thérapeutiques , Tumeurs du crâne , Imagerie diagnostique , TomodensitométrieRésumé
<p><b>INTRODUCTION</b>This is a retrospective study aimed to analyse the outcomes of oral tongue cancer with emphasis on young people.</p><p><b>MATERIALS AND METHODS</b>Patients treated radically between 1998 and 2006 were included and categorised according to treatment modalities (Group A: Surgery, Group B: Surgery and adjuvant therapy, Group C: Definitive radiotherapy) and age groups (≤ 40 and > 40 years). Overall survival (OS), disease-free survival (DFS), locoregional relapse-free survival (LRS) and metastasis-free survival (MFS) were estimated using Kaplan-Meier method.</p><p><b>RESULTS</b>There were 123 patients with 32%, 53% and 15% in Group A, B and C, respectively. Of these, 17 patients (14%) were ≤40 years with 6 (15%), 8 (12%) and 3 (16%) young oral tongues in Group A, B and C, respectively. Five-year OS and DFS were 69%/72%, 41%/47% and 16%/9.5% for Group A, B and C, respectively. Young patients had similar survival as the older population with 5-year OS of 83%, 75% and 33% in Group A, B and C, as compared to the older patients (66%, 36% and 13%, respectively).</p><p><b>CONCLUSION</b>Young oral tongue patients did not have worse outcomes.</p>