| Budget Amount *help |
¥3,770,000 (Direct Cost: ¥2,900,000、Indirect Cost: ¥870,000)
Fiscal Year 2010: ¥1,040,000 (Direct Cost: ¥800,000、Indirect Cost: ¥240,000)
Fiscal Year 2009: ¥2,730,000 (Direct Cost: ¥2,100,000、Indirect Cost: ¥630,000)
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| Research Abstract |
We evaluated the prognostic impact of age in localized renal cell carcinoma (RCC) patients, and then investigated the incidence of Xp11 translocation RCC in young patients who developed recurrence. Between 1990 and 2007, 2,403 Japanese patients underwent nephrectomy for presumed RCC at 9 institutions. Of those, 1,143 patients had localized RCC (pT1-2N0M0) ; their clinical data were reviewed retrospectively. In this study, 131 patients (11%) were considered young (≦45 years at diagnosis). In young patients with recurrence, nephrectomy specimens were TFE3 immunostained to determine the incidence of Xp11 translocation RCC. During the median follow-up of 47 months, 3 (2.2%) cancer deaths occurred among young patients and 51 (5.0%) occurred among older patients. The 5-year cancer-specific survival (CSS) rate was significantly better for young patients than for older patients (p=0.049). Multivariate analysis showed that age was significantly associated with CSS, as were pathologic T stage, tumor grade and symptom at diagnosis. The hazard ratio of young age was 0.31 (95% CI : 0.077-0.87). Meanwhile, recurrence-free survival (RFS) curves revealed no difference between these two groups. Among the 74 recurrent patients, CSS after recurrence was significantly better in young patients than in older patients (p=0.0010). Of the eight recurrent young patients, four had Xp11 translocation RCC ; three of these survived for more than 5 years after recurrence. In conclusion, compared to older patients, young RCC patients have similar RFS rates but better CSS rates. This may be because significant numbers of young patients have Xp11 translocation RCC.
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