renal cell cancer

肾细胞癌
  • 文章类型: Journal Article
    在我们最近的研究中,我们探讨了三维(3D)测量肿瘤体积在预测肾细胞癌(RCC)患者生活质量(QoL)改善中的功效,接受阿西替尼和抗PD-L1抗体治疗的患者。这项研究包括18例RCC患者,包括10名男性和8名女性,平均年龄56.83±9.94岁。通过利用3D切片器软件,我们分析了治疗前后的CT扫描,以评估肿瘤体积的变化.通过FKSI-DRS问卷评估患者的QoL。我们的研究结果表明,所有患者的3D模型都被成功创建,基于RECIST1.1标准的治疗应答分类与体积分析之间存在中度一致性(kappa=0.556,p=0.001).值得注意的是,9例患者报告治疗后QoL有临床意义的改善.有趣的是,与CT测量的直径变化相比,3D模型显示的肿瘤体积变化在预测QoL改善方面显示出更高的曲线下面积,尽管这种差异没有统计学意义(z=0.593,p=0.553).此外,一项多变量分析将基于3D模型的肿瘤体积变化确定为QoL改善的独立预测因子(比值比=1.073,95%CI1.002-1.149,p=0.045).总之,我们的研究表明,与传统的基于CT的直径测量相比,通过3D模型测量的肿瘤体积变化可能更有效地预测RCC患者的症状改善.这提供了一种评估治疗反应和患者健康状况的新方法,在RCC治疗领域取得了重大进展。
    In our recent study, we explored the efficacy of three-dimensional (3D) measurement of tumor volume in predicting the improvement of quality of life (QoL) in patients suffering from renal cell cancer (RCC), who were treated with axitinib and anti-PD-L1 antibodies. This study encompassed 18 RCC patients, including 10 men and 8 women, with an average age of 56.83 ± 9.94 years. By utilizing 3D Slicer software, we analyzed pre- and post-treatment CT scans to assess changes in tumor volume. Patients\' QoL was evaluated through the FKSI-DRS questionnaire. Our findings revealed that 3D models for all patients were successfully created, and there was a moderate agreement between treatment response classifications based on RECIST 1.1 criteria and volumetric analysis (kappa = 0.556, p = 0.001). Notably, nine patients reported a clinically meaningful improvement in QoL following the treatment. Interestingly, the change in tumor volume as indicated by the 3D model showed a higher area under the curve in predicting QoL improvement compared to the change in diameter measured by CT, although this difference was not statistically significant (z = 0.593, p = 0.553). Furthermore, a multivariable analysis identified the change in tumor volume based on the 3D model as an independent predictor of QoL improvement (odds ratio = 1.073, 95% CI 1.002-1.149, p = 0.045).In conclusion, our study suggests that the change in tumor volume measured by a 3D model may be a more effective predictor of symptom improvement in RCC patients than traditional CT-based diameter measurements. This offers a novel approach for assessing treatment response and patient well-being, presenting a significant advancement in the field of RCC treatment.
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  • 文章类型: Systematic Review
    肾细胞癌(RCC)是一种发病率和复发率都很高的肿瘤。循环肿瘤细胞(CTCs)在肾癌中的应用仍存在争议。因此,我们进行了一项荟萃分析,以阐明CTC在RCC中的诊断和预后价值.为了得到一个准确的结论,在Pubmed进行了系统的搜索,Cochrane数据库,Embase和WebofScience至2022年12月1日。我们还进一步确定了相关研究中的参考文献。诊断准确性变量(灵敏度,特异性)和比值比(ORs)以及相应的95%置信区间(CIs)用于获取CTC的准确性以及CTC与疾病分期之间的关系,分别。异质性检验,敏感性分析,还应用了元回归和发表偏差。共有12项研究涉及767名患者被认为包括在最终的荟萃分析中。结果表明,总体灵敏度,肾癌中CTC检测的特异性分别为45%(95CI,32-60%)和99%(95CI,97-100%),分别。在亚组分析中,CTC在透明细胞肾细胞癌(ccRCC)中的诊断敏感性(69%,95CI;50-88%)显著高于其他RCC亚型(34%,95CI;21-48%)(p<0.05)。同时,晚期疾病(III-IV期)比局部疾病(I-II期)更容易发现CTC(OR,2.29;95CI,1.37-3.83;p=0.002)。这项系统评价和荟萃分析表明,CTC检测可以被认为是RCC的一种有前途的辅助诊断和分期方法。尤其是ccRCC亚型。同时,细胞角蛋白阳性CTC的存在很可能与RCC不良预后风险增加相关.
    Renal cell carcinoma (RCC) is a type of tumor with high morbidity and recurrence rates. The application of circulating tumor cells (CTCs) in RCC remains controversial. Hence, we performed a meta-analysis to elucidate the diagnostic and prognostic value of CTCs in RCC. To obtain a precise conclusion, a systematic search was conducted in Pubmed, Cochrane Database, Embase and Web of Science up to Dec 01, 2022. We also further identified the references in relevant studies. The diagnostic accuracy variables (sensitivity, specificity) and odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were used to access precise of CTCs and relationship between CTCs and disease stages, respectively. Heterogeneity test, sensitivity analysis, meta-regression and publishing bias were also applied. A total of 12 studies involving 767 patients were considered to be included in the final meta-analysis. The results revealed that the overall sensitivity, specificity of CTC detection in RCC were 45% (95%CI, 32-60%) and 99% (95%CI, 97-100%), respectively. In subgroup analysis, diagnostic sensitivity of CTCs in clear cell renal cell carcinoma (ccRCC) (69%, 95%CI; 50-88%) was significantly higher than other RCC subtypes (34%, 95%CI; 21-48%) (p<0.05). Meanwhile, advanced diseases (stage III-IV) were more likely to find CTCs than localized diseases (stage I-II) (OR, 2.29; 95%CI, 1.37-3.83; p = 0.002). This systematic review and meta-analysis demonstrated that CTC detection could be considered as a promising auxiliary diagnostic and staging method for RCC, especially ccRCC subtype. Meanwhile, the presence of cytokeratin-positive CTCs is highly likely associated with increased risk of poor prognosis in RCC.
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  • 文章类型: Systematic Review
    他汀可能赋予抗癌功效,而评估他汀类药物对肾细胞癌(RCC)患者生存率影响的研究得出的结果不一致。进行了系统评价和荟萃分析,以研究他汀类药物使用与RCC患者生存之间的关系。
    队列研究是通过搜索PubMed,Embase,和WebofScience数据库,根据荟萃分析的目标。将纳入研究间可能的异质性的随机效应模型用于荟萃分析。还根据研究特征进行了亚组分析。
    共有17项队列研究,涉及42528例RCC患者,可用于荟萃分析。结果显示,他汀类药物的使用与更好的总生存率(OS,风险比[HR]:0.73,95%置信区间[CI]:0.65至0.84,p<0.001;I2=40%),无进展进展生存期(PFS,HR:0.82,95%CI:0.68至0.98,p=0.03;I2=52%),和癌症特异性生存率(CSS,HR:0.76,95%CI:0.59至0.99,p=0.04;I2=38%)。此外,对于OS和PFS的结果,亚组分析显示,在接受手术和非手术抗癌治疗的患者中结果相似,在I-III期和IV期RCC患者中(P值亚组差异均>0.05)。
    他汀类药物的使用可能与RCC患者生存结局的改善相关。尽管应该考虑前瞻性临床研究来验证这些结果,这些发现提示他汀类药物可能是RCC患者的潜在辅助治疗.
    UNASSIGNED: Statin may confer anticancer efficacy, while the studies evaluating the influence of statin on survival of patients with renal cell cancer (RCC) yielded inconsistent results. A systematic review and meta-analysis was performed to investigate the association between statin use and survival of patients with RCC.
    UNASSIGNED: Cohort studies were identified by search of PubMed, Embase, and Web of Science databases according to the objective of the meta-analysis. A random-effect model incorporating the possible between-study heterogeneity was used for meta-analysis. Subgroup analyses according to study characteristics were also performed.
    UNASSIGNED: Seventeen cohort studies involving 42528 patients with RCC were available for the meta-analysis. Results showed that statin use was associated with a better overall survival (OS, hazard ratio [HR]: 0.73, 95% confidence interval [CI]: 0.65 to 0.84, p < 0.001; I2 = 40%), progression progression-free survival (PFS, HR: 0.82, 95% CI: 0.68 to 0.98, p = 0.03; I2 = 52%), and cancer-specific survival (CSS, HR: 0.76, 95% CI: 0.59 to 0.99, p = 0.04; I2 = 38%). Besides, for the outcome of OS and PFS, subgroup analyses showed similar results in patients with surgical and non-surgical anticancer treatments, and in patients with stage I-III and stage IV RCC (p values for subgroup difference all > 0.05).
    UNASSIGNED: Statin use may be associated with improved survival outcomes in patients with RCC. Although prospective clinical studies should be considered to validate these results, these findings suggest that statins may be potential adjuvant therapy for patients with RCC.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Journal Article
    Renal cell carcinoma accounts for 2-3% of all cancers. It is difficult to diagnose early. Recently, genome-wide studies have identified that histone methylation was one of the functional classes that is most frequently dysregulated in renal cell cancer. Mutation or mis-regulation of histone methylation, methyltransferases, demethylases are associated with gene expression and tumor progression in renal cell cancer. Herein, we summarize histone methylations, demethylases and their alterations and mechanisms in renal cell cancer.
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  • 文章类型: Journal Article
    研究表明,约30%的肾癌患者会发生转移,淋巴结转移(LNM)可能与预后不良有关。我们的回顾性研究旨在提供一种可靠的基于机器学习的模型来预测肾癌中LNM的发生。我们筛选了病理分级,肝转移,M分期,主站点,T分期,来自SEER数据库组成的训练组(n=39016)和医疗中心组成的验证组(n=771)的肿瘤大小。癌症患者LNM的独立预测因子。使用六种不同的算法建立预测模型,发现XGB模型在训练组和验证组中的预测性能明显优于其他任何机器学习模型。结果表明,基于机器学习的预测工具能够准确预测肾癌患者发生LNM的概率,具有令人满意的临床应用前景。
    淋巴结转移(LNM)与肾癌患者的预后相关。这项研究旨在提供可靠的基于机器学习(基于ML)的模型来预测肾癌中LNM的概率。
    从监测中提取诊断为肾癌的患者的数据,2010年至2017年的流行病学和结果(SEER)数据库,并通过最小绝对收缩和选择运算符(LASSO)过滤变量,单变量和多变量逻辑回归分析。使用具有统计学意义的风险因素来建立预测模型。我们在模型的验证中使用了10倍交叉验证。接收器工作特征曲线下面积(AUC)用于评估模型的性能。相关热图用于使用置换分析来研究特征的相关性,以评估预测因子的重要性。概率密度函数(PDF)和临床效用曲线(CUC)用于确定临床效用阈值。
    这项研究的训练队列包括39,016名患者,验证队列包括771例患者.在这两个队列中,2544(6.5%)和66(8.1%)患者患有LNM,分别。病理分级,肝转移,M阶段,主站点,T级,肿瘤大小是LNM的独立预测因素。在两个模型验证中,XGB模型的AUC值为0.916,显著优于任何机器学习模型.Web计算器(https://share。streamlite.io/liuwencai4/肾_lnm/主/肾_lnm。py)是基于XGB模型构建的。基于PDF和CUC,我们建议54.6%作为指导LNM诊断的阈值概率,这可以区分大约89%的LNM患者。
    基于机器学习的预测工具能够准确指示肾癌患者发生LNM的概率,在临床实践中具有良好的应用前景。
    Studies have shown that about 30% of kidney cancer patients will have metastasis, and lymph node metastasis (LNM) may be related to a poor prognosis. Our retrospective study aims to provide a reliable machine learning-based model to predict the occurrence of LNM in kidney cancer. We screened the pathological grade, liver metastasis, M staging, primary site, T staging, and tumor size from the training group (n=39016) formed by the SEER database and the validation group (n=771) formed by the medical center. Independent predictors of LNM in cancer patients. Using six different algorithms to build a prediction model, it is found that the prediction performance of the XGB model in the training group and the validation group is significantly better than any other machine learning model. The results show that prediction tools based on machine learning can accurately predict the probability of LNM in patients with kidney cancer and have satisfactory clinical application prospects.
    Lymph node metastasis (LNM) is associated with the prognosis of patients with kidney cancer. This study aimed to provide reliable machine learning-based (ML-based) models to predict the probability of LNM in kidney cancer.
    Data on patients diagnosed with kidney cancer were extracted from the Surveillance, Epidemiology and Outcomes (SEER) database from 2010 to 2017, and variables were filtered by least absolute shrinkage and selection operator (LASSO), univariate and multivariate logistic regression analyses. Statistically significant risk factors were used to build predictive models. We used 10-fold cross-validation in the validation of the model. The area under the receiver operating characteristic curve (AUC) was used to assess the performance of the model. Correlation heat maps were used to investigate the correlation of features using permutation analysis to assess the importance of predictors. Probability density functions (PDFs) and clinical utility curves (CUCs) were used to determine clinical utility thresholds.
    The training cohort of this study included 39,016 patients, and the validation cohort included 771 patients. In the two cohorts, 2544 (6.5%) and 66 (8.1%) patients had LNM, respectively. Pathological grade, liver metastasis, M stage, primary site, T stage, and tumor size were independent predictive factors of LNM. In both model validation, the XGB model significantly outperformed any of the machine learning models with an AUC value of 0.916.A web calculator (https://share.streamlit.io/liuwencai4/renal_lnm/main/renal_lnm.py) were built based on the XGB model. Based on the PDF and CUC, we suggested 54.6% as a threshold probability for guiding the diagnosis of LNM, which could distinguish about 89% of LNM patients.
    The predictive tool based on machine learning can precisely indicate the probability of LNM in kidney cancer patients and has a satisfying application prospect in clinical practice.
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  • 文章类型: Journal Article
    辣椒素(CAP),从辣椒果实中提取,据报道,在各种癌细胞系中表现出抗肿瘤作用。然而,其抗肿瘤功效的潜在机制尚不完全清楚。自噬是细胞维持稳态的基本自我降解过程,在肿瘤发生和发展中起着有争议的作用。EMT被定义为通过多种内部和外部因素调节细胞从上皮样表型转化为间充质表型的系统。随着细胞的转移性能发展。本研究旨在探讨自噬在CAP诱导的肾细胞癌(RCC)786-O和CAKI-1细胞系中的潜在作用。结果表明,CAP对体外培养的RCC细胞的迁移、侵袭和体内转移均有明显的抑制作用。此外,我们发现CAP处理增加了RCC细胞中自噬溶酶体液泡和LC3黄色和红色荧光点的形成,并上调了LC3的表达,表明CAP在786-O和CAKI-1细胞系中诱导了自噬。我们的进一步结果表明,CAP诱导的自噬是由AMPK/mTOR通路介导的。总之,我们的研究提供了关于自噬与CAP诱导的转移抑制之间潜在关系的新知识,这可能是RCC的一种有希望的治疗策略。
    Capsaicin (CAP), extracted from Capsicum fruits, has been reported to exhibit antitumor effects in various lines of cancer cells. However, the mechanism underlying its antitumor efficiency is not fully understood. Autophagy is a fundamental self-degradation process of cells that maintains homeostasis and plays a controversial role in tumor initiation and progression. The EMT is defined as a system regulating cells transformed from an epithelial-like phenotype into a mesenchymal phenotype by several internal and external factors, following the metastatic performance of the cells developed. The present study aimed to investigate the potential role of autophagy in CAP-induced antitumor effects in renal cell carcinoma (RCC) 786-O and CAKI-1 cell lines. The results revealed that CAP remarkably inhibited the migration and invasion of RCC cells in vitro and metastasis in vivo. Moreover, we found that the CAP treatment increased the formation of autophagolysosome vacuoles and LC3 yellow and red fluorescent puncta in RCC cells and upregulated the expression of LC3, suggesting that autophagy was induced by CAP in 786-O and CAKI-1 cell lines. Our further results demonstrated that CAP-induced autophagy was mediated by the AMPK/mTOR pathway. In conclusion, our study provides new knowledge of the potential relationship between autophagy and metastasis inhibition induced by CAP, which might be a promising therapeutic strategy in RCC.
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  • 文章类型: Journal Article
    长链非编码RNA(lncRNA)通过与RNA相互作用而参与许多类型癌症的进展和发展。DNA和蛋白质,包括DLEU7-AS1。然而,DLEU7-AS1在肾细胞癌(RCC)中的作用尚不清楚.在这项研究中,使用两种计算机预测算法来发现miR-26a-5p的潜在靶标,被确定为肿瘤抑制基因,可能是DLEU7-AS1,通过下调RCC中的coronin-3。因此,我们假设DLEU7-AS1通过沉默miR-26a-5p/coronin-3轴促进RCC.为了检验我们的假设,我们使用pmirGLO双荧光素酶报告基因试验证实DLEU7-AS1直接靶向miR-26a-5p.接下来,我们观察到DLEU7-AS1表达在RCC样本中显著上调,并与临床预后和miR-26a-5p水平呈负相关.DLEU7-AS1的敲除在体外显着抑制了RCC细胞的生长和转移,并在体内减弱了肿瘤的生长。有趣的是,外源表达的coronin-3或miR-26a-5p抑制剂治疗几乎完全挽救了DLEU7-AS1敲低诱导的细胞增殖抑制作用,移民和入侵。总之,我们的数据表明DLEU7-AS1是RCC中的癌基因,能够通过沉默miR-26a-5p/coronin-3轴来调节RCC的生长和转移,提示DLEU7-AS1可作为RCC的潜在治疗靶点和预后生物标志物。
    Long non-coding RNAs (lncRNAs) have been implicated in the progression and development of many types of cancer by interacting with RNA, DNA and proteins, including DLEU7-AS1. However, the function of DLEU7-AS1 in renal cell cancer (RCC) remains unclear. In this study, two in silico prediction algorithms were used to discover the potential target of miR-26a-5p, which was determined to be a tumor suppressor gene, possibly DLEU7-AS1, through the downregulation of coronin-3 in RCC. Thus, we hypothesized that DLEU7-AS1 promotes RCC by silencing the miR-26a-5p/coronin-3 axis. To test our hypothesis, we confirmed that DLEU7-AS1 directly targets miR-26a-5p using the pmirGLO dual-luciferase reporter assay. Next, we observed that DLEU7-AS1 expression was markedly upregulated in RCC samples and inversely correlated with clinical prognosis and miR-26a-5p levels. Knockdown of DLEU7-AS1 significantly suppressed the growth and metastasis of RCC cells in vitro and attenuated tumor growth in vivo. Interestingly, exogenous expression of coronin-3 or miR-26a-5p inhibitor treatment almost completely rescued the DLEU7-AS1 knockdown-induced inhibitory effects on cell proliferation, migration and invasion. In conclusion, our data demonstrate that DLEU7-AS1 is an oncogene in RCC capable of regulating the growth and metastasis of RCC by silencing the miR-26a-5p/coronin-3 axis, suggesting that DLEU7-AS1 can be employed as a potential therapeutic target and prognostic biomarker for RCC.
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  • 文章类型: Systematic Review
    代谢综合征(MetS)与多种癌症的风险增加有关。然而,MetS与肾细胞癌(RCC)风险之间的关联仍未完全确定.这项荟萃分析旨在调查MetS是否与成人RCC的风险独立相关。
    通过搜索PubMed,Embase,科克伦图书馆,和WebofScience数据库。研究特征和结果数据由两名作者独立提取。考虑到研究间异质性的可能影响,使用随机效应模型进行荟萃分析。使用预定义的亚组分析来评估研究特征对结果的可能影响。
    涉及10,601,006名参与者的8项研究为荟萃分析做出了贡献。结果显示,在成年人群中,MetS与较高的RCC风险独立相关(风险比[RR]:1.62,95%置信区间[CI]:1.41至1.87,p<0.001;I2=85%)。亚组分析显示,男性(RR:1.52,95%CI:1.23至1.89,p<0.001)和女性(RR:1.71,95%CI:1.28至2.27,p<0.001)的相关性一致。亚洲人(RR:1.51,95%CI:1.25至1.83,p<0.001)和高加索人(RR:1.76,95%CI:1.46至2.12,p<0.001),社区来源的(RR:1.56,95%CI:1.34至1.82,p<0.001)和非社区来源的人群(RR:1.87,95%CI:1.71至2.04,p<0.001)。研究设计或质量评分的差异也没有显着影响相关性(亚组差异均>0.05)。
    MetS可能与成年人群的RCC独立相关。
    UNASSIGNED: Metabolic syndrome (MetS) has been related to increased risks of a variety of cancers. However, the association between MetS and the risk of renal cell cancer (RCC) remains not fully determined. This meta-analysis was conducted to investigate whether MetS is independently associated with the risk of RCC in adults.
    UNASSIGNED: Relevant observational studies were obtained by searching PubMed, Embase, Cochrane\'s Library, and Web of Science databases. Study characteristics and outcome data were extracted independently by two authors. The random-effect model was used for meta-analysis considering the possible influence of between-study heterogeneity. Predefined subgroup analyses were used to evaluate the possible influences of study characteristics on the outcome.
    UNASSIGNED: Eight studies involving 10,601,006 participants contributed to the meta-analysis. Results showed that MetS was independently associated with a higher risk of RCC in adult population (risk ratio [RR]: 1.62, 95% confidence interval [CI]: 1.41 to 1.87, p<0.001; I2 = 85%). Subgroup analyses showed consistent association in men (RR: 1.52, 95% CI: 1.23 to 1.89, p<0.001) and in women (RR: 1.71, 95% CI: 1.28 to 2.27, p<0.001), in Asians (RR: 1.51, 95% CI: 1.25 to 1.83, p<0.001) and in Caucasians (RR: 1.76, 95% CI: 1.46 to 2.12, p<0.001), and in community derived (RR: 1.56, 95% CI: 1.34 to 1.82, p<0.001) and non-community derived population (RR: 1.87, 95% CI: 1.71 to 2.04, p<0.001). Differences in study design or quality score also did not significantly affect the association (p for subgroup difference both >0.05).
    UNASSIGNED: MetS may be independently associated with RCC in adult population.
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  • 文章类型: Journal Article
    随着肾细胞癌(RCC)患者的生存率不断提高,非癌症死亡原因不容忽视。肾癌患者的病因特异性死亡率尚不清楚。
    我们的研究旨在探索当代RCC幸存者的死亡模式。
    我们进行了一项回顾性队列研究,流行病学,和结束结果(SEER)数据库。我们使用标准化死亡率(SMR)来比较RCC患者与普通人群的死亡率。
    共有106,118例肾癌患者,包括39630人死亡(27%),包括在我们的研究中。总的来说,与普通美国人口相比,非癌SMR增加1.25倍(95%置信区间[CI],1.22至1.27;观察到,11,235),1.19倍(95%CI,1.14至1.24;观察到,2,014),和2.24倍(95%CI,2.11至2.38;观察到,1,110)对于阶段I/II,III,和IVRCC,分别。随着生存时间的延长,非癌症死亡原因的比例增加。共有4,273名I/II期患者(23.13%)死于RCC;死于其他原因的患者死于RCC的可能性是其3.2倍(n=14,203[76.87%]).心脏病是最常见的非癌症死亡原因(n=3,718[20.12%];SMR,1.23;95%CI,1.19-1.27)。在III期疾病患者中,3,912(25.98%)死于RCC,2,014(13.37%)死于非癌症。大多数IV期RCC患者(94.99%)在初次诊断后5年内死亡。尽管RCC是导致死亡的主要原因(n=12,310[84.65%]),IV期RCC患者的非癌症死亡风险也高于一般人群(2.24;95%CI,2.11~2.38).
    在I/II期患者中,非RCC死亡原因占RCC幸存者的3/4以上。IV期患者最有可能死于RCC;然而,死于败血症的风险增加,自杀是不容忽视的。这些数据为RCC患者的死亡原因提供了最新,最全面的评估。
    UNASSIGNED: As the survival rates of patients with renal cell carcinoma (RCC) continue to increase, noncancer causes of death cannot be ignored. The cause-specific mortality in patients with RCC is not well understood.
    UNASSIGNED: Our study aimed to explore the mortality patterns of contemporary RCC survivors.
    UNASSIGNED: We performed a retrospective cohort study involving patients with RCC from the Surveillance, Epidemiology, and End Results (SEER) database. We used standardized mortality ratios (SMRs) to compare the death rates in patients with RCC with those in the general population.
    UNASSIGNED: A total of 106,118 patients with RCC, including 39,630 who died (27%), were included in our study. Overall, compared with the general US population, noncancer SMRs were increased 1.25-fold (95% confidence intervals [CI], 1.22 to 1.27; observed, 11,235), 1.19-fold (95% CI, 1.14 to 1.24; observed, 2,014), and 2.24-fold (95% CI, 2.11 to 2.38; observed, 1,110) for stage I/II, III, and IV RCC, respectively. The proportion of noncancer causes of death increased with the extension of survival time. A total of 4,273 men with stage I/II disease (23.13%) died of RCC; however, patients who died from other causes were 3.2 times more likely to die from RCC (n = 14,203 [76.87%]). Heart disease was the most common noncancer cause of death (n = 3,718 [20.12%]; SMR, 1.23; 95% CI, 1.19-1.27). In patients with stage III disease, 3,912 (25.98%) died from RCC, and 2,014 (13.37%) died from noncancer causes. Most patients (94.99%) with stage IV RCC died within 5 years of initial diagnosis. Although RCC was the leading cause of death (n = 12,310 [84.65%]), patients with stage IV RCC also had a higher risk of noncancer death than the general population (2.24; 95% CI, 2.11-2.38).
    UNASSIGNED: Non-RCC death causes account for more than 3/4 of RCC survivors among patients with stage I/II disease. Patients with stage IV are most likely to die of RCC; however, there is an increased risk of dying from septicemia, and suicide cannot be ignored. These data provide the latest and most comprehensive assessment of the causes of death in patients with RCC.
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