Renal cell carcinoma (RCC) is a highly lethal pathology, 5-year cancer-specific survival (CSS) of patients with this a disease does not exceed 75 %. Despite the widespread introduction of the latest diagnostic and therapeutic technologies, mortality in the RCC remains at almost the same level over the past 20 years. CSS and the risk of metastases in patients with RCC, in particular after surgery, depend on a variety of factors, among which the stage of the tumor, the histological subtype of the lesion and the degree of its differentiation play a leading role. A number of studies have demonstrated the independent prognostic role in duration of CSS of a number of other factors, such as the general performance status of the patient, the erythrocyte sedimentation rate (ESR) before the operation, the indicators of the blood shedding system, molecular markers, and others. At the same time, there is still no consensus on the criteria that should be included in modern prognostic systems for RCC, which necessitates further study of this issue.
The aim of the study was to investigate the correlation between clinical and survival indices in patients with the RCC.
The study included 343 patients with RCC. In total 38 clinical indices of patients with RCC were analyzed in order to estimate the correlation between them and four main parameters of survival: time to recurrence (TTR), 3-year CSS, time from diagnosis to death (DD) and time from metastasis to death (MD). The Pearson correlation coefficient was calculated for each pair of clinical and survival parameters. The Microsoft Excel 2016 software was used to statistically process the received data.
There was weak correlation between immunologic clinical indices and survival parameters in patients with RCC. However, we observed strong correlation between CSS, TRR, DD, MD and 8 clinical parameters of the RCC: pre-operational sedimentation rate, Karnofsky general performance status, stage of the tumor, T, N and M stages as a separate factors, grade of nuclear atypia and histologic subtype of the RCC (p < 0.05). Medium correlation between survival and clinical parameters was observed for tumor necrosis, state of the tumor capsule, size of the tumor, type of the tumor growth (p < 0.05). Thus, among patients with RCC TNM stage I, the average ESR before surgery was 17.9 mm/h, among patients with stage II – 25.0 mm/h, among patients of the third stage – 35.2 mm/h, and among patients in stage IV – 43.4 mm/h. The general performance status of the patient was also quite noticeably associated with the stage of the tumor process. The average score of the Karnofsky scale for T1 tumors was 90, for tumors T2 – 80, T3 – 50 tumors and T4 – 30 tumors.
Among 38 clinical indices, which were investigated, only 8 demonstrated strong correlation with survival parameters in patients with RCC. Further investigations are required in order to validate obtained data and development of the prognostic system.
Keywords: renal-cell carcinoma, prognosis, survival, metastasis
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