索拉非尼治疗中国西北地区转移性肾癌患者总生存期预后的多因素分析  

Multivariate analysis on the prognostic factors of overall survival in patients with metastatic renal cell carcinoma treated by sorafenib in Northwest China

作　　者：郑昱[1] 武国军[1] 王福利[1] 闫飞[1] 秦军[1] 秦卫军[1] 袁建林[1] 张龙龙[1] 马帅军[1] 魏迪[1] 叶永利[1] 田春娟[1] 

机构地区：[1]第四军医大学附属西京医院泌尿外科,西安710032

出　　处：《现代泌尿生殖肿瘤杂志》2015年第6期327-331,共5页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨索拉非尼治疗转移性肾癌（mRCC）患者总生存期（OS）预后相关的危险因素。方法回顾性研究来自中国西北地区10个中心接受索拉非尼治疗的mRCC患者83例,利用Log-rank检验、COX回归风险比例模型及Kaplan-Meier法,分析临床常见的23个变量,从而筛选出和患者OS相关的预后因素。结果 69例可评价患者中位OS为29.0个月,多因素分析结果显示未手术切除原发灶（OR4.838,95%CI1.638-14.289,P=0.004）、器官转移病灶≥2个（OR2.821,95%CI1.410-5.645,P=0.003）、Fuhrman分级≥3级（OR2.810,95%CI1.424-5.543,P=0.003）以及ECOG评分≥1分（OR2.467,95%CI1.110-5.480,P=0.027）是其独立危险因素。按照危险因素将患者分为低危组（无危险因素）,中危组（1-2种危险因素）,高危组（3-4种危险因素）,各组中位OS分别为42.0、24.0及21.0个月,P=0.000。结论未手术切除原发灶、器官转移病灶≥2个、Fuhrman分级≥3级以及ECOG评分≥1分是mRCC患者接受索拉非尼治疗中位OS的独立危险因素。基于以上4种危险因素的评分标准可以指导对索拉非尼治疗mRCC患者OS预后的评价。这一结论仍需大样本前瞻性研究证实。Objective To explore the risk factors associated with overall survival（OS）for metastatic renal cell carcinoma（mRCC）patients treated by sorafenib. Methods A retrospective study of 83 patients with mRCC treated by sorafenib from 10 centers in Northwest China was implemented.The Log-rank test,multivariable COX proportional hazards model and Kaplan-Meier method were used to screen out prognostic risk factors associated with OS. Results 69 cases of patients can be evaluated with a median OS was 29.0 months.Multivariate analysis showed no surgical resection of the primary tumor（OR 4.838,95%CI 1.638-14.289,P=0.004）,organ metastases lesions≥2（OR 2.821,95%CI1.410-5.645,P=0.003）,Fuhrman grade≥3（OR 2.810,95%CI 1.424-5.543,P=0.003）and ECOG score≥1（OR 2.467,95%CI1.110-5.480,P=0.027）were independent risk factors of OS.Patients were divided into favorable group（no risk factor）,intermediate group（1-2 risk factors）and poor group（3-4 risk factors）and the median OS were 42.0,24.0,21.0months,respectively,P=0.000. Conclusions No surgical resection of the primary tumor,organ metastases lesions≥2,Fuhrman grade≥3 and ECOG score≥1 are independent risk factors of OS for mRCC patients treated by sorafenib.Based on the above 4 risk factors,the evaluation criteria can be used to guide the sorafenib therapy for mRCC patients.However,more samples of prospective study are still need to explore.

关 键 词：肾细胞癌 索拉非尼 总生存期 预后因素 

分 类 号：R737.11[医药卫生—肿瘤]