Application of the revised Tumour Node Metastasis （TNM） staging system of clear cell renal cell carcinoma in eastern China： advantages and limitations

作     者：Chao Qin Li-Jiang Sun Li Cui Qiang Cao Jian Zhu Pu Li Gui-Ming Zhang Xin Mao Peng-Fei Shao Mei-Lin Wang Zheng-Dong Zhang Min Gu Wei Zhang Chang-Jun Yin 

作者机构：Department of Urology The First Affiliated Hospital of Nanjing Medical University Nanjing 210029 China Department of Urology The Affiliated Hospital of Medical College Qingdao University Qingdao 266001 China Department of Urology The Third Affiliated Hospital of Soochow University Changzhou 213003 China and Department of Molecular and Genetic Toxicology School of Public Health Nanjing Medical University Nanjing 210029 China 

出 版 物：《Asian Journal of Andrology》 (亚洲男性学杂志（英文版）)

年 卷 期：2013年第15卷第4期

页      面：550-557,I0011页

核心收录：

学科分类：0831[工学-生物医学工程（可授工学、理学、医学学位）] 083002[工学-环境工程] 0830[工学-环境科学与工程（可授工学、理学、农学学位）] 1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 07[理学] 08[工学] 09[农学] 0903[农学-农业资源与环境] 0713[理学-生态学] 10[医学] 

基　　金：supported by the Program for Development of Innovative Research Team of the First Affiliated Hospital of Nanjing Medical University the Provincial Initiative Program for Excellency Disciplines, Jiangsu Province and the National Natural Science Foundation of China 

主　　题：kidney neoplasm prognosis renal cell carcinoma TNM stage 

摘      要：This study was designed to evaluate whether the revised 2010 Tumour Node Metastasis （TNM） staging system could lead to a more accurate prediction of the prognosis of renal cell carcinoma （RCC） patients. A total of 1216 patients who had undergone radical nephrectomy or partial nephrectomy for RCC from 2003 to 2011 were enrolled. All of the patients had pathologically confirmed clear cell RCC （ccRCC）. All cases were staged by both the 2002 and 2010 TNM staging systems after pathological review, and survival data were collected. Univariate and multivariate Cox regression models were used to evaluate cancer-specific survival （CSS） and progression-free survival （PFS） after surgery. Continuous variables, such as age and tumour diameter, were calculated as mean values and standard deviations （s.d.） or as median values. Survival was calculated by the Kaplan-Meier method, and the log-rank test assessed differences between groups. Statistically significant differences in CSS and PFS were noted among patients in T3 subgroups using the new 2010 staging system. Therefore, the revised 2010 TNM staging system can lead to a more accurate prediction of the prognosis of ccRCC patients. However, when using the revised 2010 staging system, we found that more than 92% of patients （288/313） with T3 tumours were staged in the T3a subgroup, and their survival data were not significantly different from those of patients with T2b tumours. In addition, T2 subclassification failed to independently predict survival in RCC patients.