Prognostic Value of the Lung Immune Prognostic Index on Recurrence after Radical Surgery for High-Risk Renal Cell Carcinoma
Abstract
:Simple Summary
Abstract
1. Introduction
2. Materials and Methods
2.1. Patient Selection and Data Collection
2.2. Surgery and Follow-Up Protocol
2.3. Study Design and Statistical Analyses
3. Results
3.1. Patient Characteristics
3.2. RFS According to LIPI Groups
3.3. Factors Associated with RFS
3.4. Additive Role of the LIPI to Preexisting Prediction Models
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Overall 235 | Good LIPI = 0 119 (50.6%) | Intermediate LIPI = 1 91 (38.7%) | Poor LIPI = 2 25 (10.6%) | p | |
---|---|---|---|---|---|
Age, years (median [IQR]) | 67.0 [61.0–73.0] | 67.0 [61.5–74.0] | 66.0 [61.5–72.0] | 69.0 [57.0–74.0] | 0.915 |
Sex, male (%) | 166 (70.6) | 84 (70.6) | 65 (71.4) | 17 (68.0) | 0.946 |
ECOG-PS (%) | 0.359 | ||||
0 | 196 (83.4) | 102 (85.7) | 72 (79.1) | 22 (88.0) | |
≥1 | 39 (16.6) | 17 (14.3) | 19 (20.9) | 3 (12.0) | |
Symptoms at diagnosis | 104 (44.3) | 65 (54.6) | 31 (34.1) | 8 (32.0) | 0.011 |
None | 95 (40.4) | 42 (35.3) | 43 (47.3) | 10 (40.0) | |
Local | 36 (15.3) | 12 (10.1) | 17 (18.7) | 7 (28.0) | |
Systemic | 104 (44.3) | 65 (54.6) | 31 (34.1) | 8 (32.0) | |
Tumor size, mm (median [IQR]) | 77.0 [59.0–100.0] | 74.5 [57.0–90.0] | 85.0 [61.5–107.0] | 91.0 [65.0–113.0] | 0.014 |
Pathological T stage (%) | <0.001 | ||||
T1/T2 | 62 (26.4) | 42 (35.3) | 17 (18.7) | 3 (12.0) | |
T3a | 101 (43.0) | 57 (47.9) | 35 (38.5) | 9 (36.0) | |
T3b | 47 (20.0) | 11 (9.2) | 26 (28.6) | 10 (40.0) | |
T3c | 20 (8.5) | 8 (6.7) | 9 (9.9) | 3 (12.0) | |
T4 | 5 (2.1) | 1 (0.8) | 4 (4.4) | 0 (0.0) | |
pN stage (%) | |||||
N0/Nx | 212 (90.2) | 109 (91.6) | 78 (85.7) | 25(100.0) | 0.080 |
N1 | 23 (9.8) | 10 (8.4) | 13 (14.3) | 0 (0.0) | |
Pathological histology (%) | 0.034 | ||||
Clear cell | 202 (86.0) | 108 (90.8) | 76 (83.5) | 18 (72.0) | |
Non-clear cell | 33 (14.0) | 11 (9.2) | 15 (16.5) | 7 (28.0) | |
Tumor grade (%) | 0.041 | ||||
1 | 16 (6.8) | 10 (8.4) | 5 (5.5) | 1 (4.0) | |
2 | 97 (41.3) | 57 (47.9) | 32 (35.2) | 8 (32.0) | |
3 | 89 (37.9) | 44 (37.0) | 34 (37.4) | 11 (44.0) | |
4 | 33 (14.0) | 8 (6.7) | 20 (22.0) | 5 (20.0) | |
Recurrence | 126 (53.6) | 47 (39.5) | 61 (67.0) | 18 (72.0) | <0.001 |
Follow-up periods, months | 19.8 [5.9–48.3] | 31.8 [9.4–62.7] | 12.6 [3.8–30.5] | 9.1 [4.0–16.8] | <0.001 |
Univariate | Multivariate | |||||
---|---|---|---|---|---|---|
HR | 95% CI | p | HR | 95% CI | p | |
Age (continuous) | 1.00 | 0.99–1.02 | 0.837 | 1.00 | 0.98–1.02 | 0.836 |
Sex | ||||||
Male | Ref | Ref | ||||
Female | 1.01 | 0.69–1.49 | 0.953 | 0.86 | 0.56–1.33 | 0.503 |
Presence of symptoms | ||||||
None | Ref | |||||
Local | 2.27 | 1.50–3.43 | 0.000 | 2.06 | 1.31–3.23 | 0.002 |
Systemic | 4.34 | 2.65–7.11 | 0.000 | 2.19 | 1.26–3.82 | 0.006 |
ECOG-PS | ||||||
0 | Ref | |||||
≥1 | 1.67 | 1.07–2.60 | 0.025 | 1.65 | 1.00–2.71 | 0.049 |
Tumor size (continuous) | 1.01 | 1.00–1.01 | 0.001 | 1.01 | 1.00–1.01 | 0.062 |
pT | ||||||
T1/T2 | Ref | Ref | ||||
T3a | 2.43 | 1.45–4.07 | 0.001 | 2.26 | 1.30–3.91 | 0.004 |
T3b | 3.64 | 2.08–6.36 | 0.000 | 2.37 | 1.25–4.51 | 0.009 |
T3c | 5.78 | 2.90–11.56 | 0.000 | 4.57 | 2.14–9.75 | <0.001 |
T4 | 5.97 | 2.03–17.56 | 0.001 | 5.80 | 1.76–19.10 | 0.004 |
pN | ||||||
N0/Nx | Ref | |||||
N1 | 2.28 | 1.37–3.82 | 0.002 | 4.05 | 2.09–7.84 | <0.001 |
Tumor grade | ||||||
1 | Ref | Ref | ||||
2 | 1.66 | 0.66–4.19 | 0.286 | 1.35 | 0.51–3.54 | 0.549 |
3 | 3.28 | 1.31–8.26 | 0.011 | 2.43 | 0.92–6.44 | 0.074 |
4 | 6.48 | 2.45–17.16 | 0.000 | 2.94 | 1.05–8.25 | 0.040 |
Histology | ||||||
Clear cell | Ref | Ref | ||||
Non-clear cell | 1.84 | 1.18–2.89 | 0.008 | 1.30 | 0.75–2.26 | 0.349 |
LIPI | ||||||
Good (0) | Ref | Ref | ||||
Intermediate (1) | 2.32 | 1.58–3.41 | 0.000 | 1.59 | 1.04–2.44 | 0.033 |
Poor (2) | 3.76 | 2.15–6.57 | 0.000 | 2.73 | 1.41–5.28 | 0.003 |
dNLR | ||||||
Continuous | 1.23 | 1.09–1.38 | 0.001 | NA | ||
≥2.28 (Ref: <2.28) | 2.14 | 1.50–3.06 | 0.000 | NA | ||
LDH | ||||||
Continuous | 1.74 | 1.39–2.19 | 0.000 | NA | ||
≥UNL (Ref: <UNL) | 2.13 | 1.45–3.14 | 0.000 | NA |
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Ishiyama, Y.; Kondo, T.; Yoshida, K.; Iizuka, J.; Takagi, T. Prognostic Value of the Lung Immune Prognostic Index on Recurrence after Radical Surgery for High-Risk Renal Cell Carcinoma. Cancers 2024, 16, 776. https://doi.org/10.3390/cancers16040776
Ishiyama Y, Kondo T, Yoshida K, Iizuka J, Takagi T. Prognostic Value of the Lung Immune Prognostic Index on Recurrence after Radical Surgery for High-Risk Renal Cell Carcinoma. Cancers. 2024; 16(4):776. https://doi.org/10.3390/cancers16040776
Chicago/Turabian StyleIshiyama, Yudai, Tsunenori Kondo, Kazuhiko Yoshida, Junpei Iizuka, and Toshio Takagi. 2024. "Prognostic Value of the Lung Immune Prognostic Index on Recurrence after Radical Surgery for High-Risk Renal Cell Carcinoma" Cancers 16, no. 4: 776. https://doi.org/10.3390/cancers16040776