Evaluation of a new prognostic score (Munich score) to predict long-term survival after resection of pulmonary renal cell carcinoma metastases

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• 作者：Georgios Meimarakis M.D.^a ; Martin Angele M.D. ; Ph.D.^a ; Michael Staehler M.D.^b ; Dirk-Andre Clevert M.D. ; Ph.D.^c ; Alexander Crispin M.D.^d ; Dominik Rü ; ttinger M.D. ; Ph.D.^a ; Florian Lö ; he M.D. ; Ph.D.^a ; Gerhard Preissler M.D.^a ; Rudolf A. Hatz M.D. ; Ph.D.^a ; Hauke Winter M.D. ; Ph.D.^a ; ^{hauke.winter@med.uni-muenchen.de"" rel=""nofollow}
• 关键词：Prognostic factors ; Pulmonary metastases ; Renal cell carcinoma ; Surgical resection ; Survival
• 刊名：The American Journal of Surgery
• 出版年：2011
• 出版时间：August 2011
• 年：2011
• 卷：202
• 期：2
• 页码：158-167
• 全文大小：872 K

文摘

Background

The aim of this single-center study was to analyze factors predicting long-term outcomes following surgical resection of pulmonary metastases in patients with renal cell carcinoma.

Methods

Two hundred two consecutive patients entered the study. Overall survival was analyzed by the Kaplan-Meier method. Multivariate analysis was performed using Cox regression models.

Results

In 175 cases (87 % ), curative resection of the pulmonary metastases was achievable, with median survival of 43 months. Multivariate analysis revealed complete metastasectomy (R0), metastasis size >3 cm, positive nodal status of the primary tumor, synchronous metastases, pleural infiltration, and tumor-infiltrated hilar or mediastinal lymph nodes as independent prognostic factors for survival. On the basis of these findings, a new scoring system (the Munich score) was established to predict survival, which discriminates 3 groups with low, intermediate, and high risk for poor outcomes (median survival, 90, 31, and 14 months, respectively, P < .001).

Conclusions

The aim of the Munich score is to define patients with low, intermediate, and high risk for poor survival and will help identify patients who may benefit from further adjuvant therapy.