Prognostic indicators of pulmonary metastasis in patients with renal cell carcinoma who have undergone radical nephrectomy

Ku,Ja  Yoon; Kim,Suk; Hong,Seung  Baek; Lee,Jong  Geun; Lee,Chan  Ho; Choi,Seock  Hwan; Ha,Hong  Koo

doi:10.3892/ol.2019.9912

Prognostic indicators of pulmonary metastasis in patients with renal cell carcinoma who have undergone radical nephrectomy

Authors:
- Ja Yoon Ku
- Suk Kim
- Seung Baek Hong
- Jong Geun Lee
- Chan Ho Lee
- Seock Hwan Choi
- Hong Koo Ha
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Affiliations: Department of Urology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea, Department of Radiology, Pusan National University Hospital, Pusan National University School of Medicine, Busan 49241, Republic of Korea, Department of Thoracic and Cardiovascular Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju 63241, Republic of Korea, Department of Urology, Busan Paik Hospital, College of Medicine, Inje University, Busan 47392, Republic of Korea, Department of Urology, School of Medicine, Kyungpook National University, Daegu 41944, Republic of Korea
Published online on: January 9, 2019 https://doi.org/10.3892/ol.2019.9912
Pages: 3009-3016

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Abstract

The aim of the present study was to validate prognostic indicators of pulmonary metastasis in patients with renal cell carcinoma (RCC) that have undergone nephrectomy treatment. The data from 356 patients who underwent nephrectomy were investigated and subsequently divided into 2 groups, according to the pulmonary metastasis status. The risk factors for pulmonary metastasis were examined in all patients. In the subgroup analysis, the risk factors were additionally verified in patients with pulmonary nodules using univariate and multivariate logistic regression analyses. The status of pulmonary nodules and pulmonary metastasis were confirmed through preoperative chest radiography by two radiologists. Pulmonary metastasis was observed in 33 (9.3%) patients with a median follow‑up time of 54.4 months (interquartile range, 38.8‑71.8). Patients with pulmonary nodules indicated significantly increased rates of pulmonary metastasis, compared with patients without pulmonary nodules (24.2 vs. 6.1%; P<0.001). In multivariate analysis, the presence of pulmonary nodules [hazard ratio (HR)=3.15; P=0.0262], albumin (HR=0.42; P=0.0490) and pTstage (HR=3.63; P=0.0475) were indicated to be independent prognostic markers for pulmonary metastasis. In subgroup analysis, pTstage was the only independent prognostic indicator for pulmonary metastasis in these patients (HR=9.81; P=0.0033). In patients with RCC, the presence of pulmonary nodules was associated with pulmonary metastasis. Furthermore, pTstage is a negative prognostic indicator in patients with pulmonary nodules. Therefore, a chest radiologic short‑term follow‑up is required for these patients.

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