RE: Chromphobe
Chromophobe Zellen bezeichnen einen bestimmten histologischen Zelltyp (zytoplasma-reich, bestimmte Färbung), der in der Niere selten (wenn überhaupt) vorkommt. Aber im Prinzip kann von jeder Zelle bzw. Zellart ein gut- oder bösartiger Tumor ausgehen. Es ist richtig, dass diese Eigenschaft eigentlich (jedenfalls nach dem heutigen Kenntnisstand) keine Bedeutung für die Prognose hat. Entscheidend ist vielmehr das Grading G2, und da sieht es bei Ihnen ganz gut aus. G2 heisst mittelgut differenziert. Die Skala geht von G1 bis G3 (G3 ist schlecht differenziert und wäre ein ungünstiger Faktor). In Studien wurde das Alter nicht als besonderer prognostischer Faktor beschrieben (s. z.B. Uno et al 2004, Int J Clin Oncol 9 (6): 510-4). Hier ist die Zusammenfassung dieser Arbeit. Aber da gibt es vieles mehr.
Prognostic factors for survival of patients after curative surgery for renal cell carcinoma: multivariate analysis of 482 cases.
Uno M, Fujimoto Y, Takada T, Ishida K, Kubota Y, Katoh S, Hagiwara N, Minamidate Y, Yokoi S, Deguchi T; Gifu RCC Research Group.
Department of Urology, Ogaki Municipal Hospital, 4-86 Minaminokawa, Ogaki, Gifu, 503-8502, Japan.
[email protected]
BACKGROUND: Even with curative surgery, renal cell carcinoma occasionally recurs in other organs, with fatal results. In this study, we identified independent prognostic factors for survival in patients with renal cell carcinoma after curative surgery. METHODS: The records of 482 patients (mean age, 61.0 years; range, 17-90 years) who underwent curative surgery for renal cell carcinoma at Gifu University Hospital and its affiliated hospitals between 1991 and 2000 were reviewed. The average follow-up period was 42 months (range, 10-140 months). Clinical characteristics of the 482 patients were divided into three categories: patient factors (sex, age, performance status, and mode of tumor discovery), tumor factors (T classification, N classification, mode of infiltration, histological grade, and venous invasion), and treatment factor (whether or not adjuvant therapy with interferon-alpha was used). Stepwise multivariate Cox proportional hazards regression modeling was performed to identify independent determinants of survival. RESULTS: Of the patient factors, performance status and mode of tumor discovery were independent factors predicting survival. Of the tumor factors, venous invasion and mode of infiltration were independent factors predicting survival. Use or non-use of adjuvant therapy was not significantly associated with survival. Overall, performance status, venous invasion, mode of infiltration, and histological grade were shown to be independent prognostic factors, in descending order of importance. CONCLUSION: Performance status, venous invasion, mode of infiltration, and histological grade, in descending order, were the most important factors predicting survival after curative surgery for renal cell carcinoma.
