Survival analysis of surgically treated renal cell carcinoma: a single Chinese medical center experience from 2002 to 2012

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Abstract
To analyze the survival and the associated factors affecting the prognosis of renal cell carcinoma (RCC) in China with a sufficiently large sample size. Clinical data with complete follow-up of 1326 RCC patients were successfully obtained. Progression-free survival (PFS) and cancer-specific survival (CSS) were calculated, survival analysis was performed by Kaplan–Meier analysis, and Cox proportional hazards regression models were served to estimate the prognostic significance of each variables. The median length of follow-up was 43.55 months (25–75 %, 25.47–68.75 months). During follow-up, 147 patients developed RCC-related progression, with a median PFS of 18.2 months (25–75 %, 7.50–47.27); 64 patients died from RCC-related progression, with a median CSS of 27.67 months (25–75 %, 14.10–58.53). For RCC patients in T1 stage, 3-, 5-, 8-, and 10-year CSS rates of patients receiving nephron-sparing nephrectomy were 99.33, 98.21, 97.40, and 97.40 %, respectively, which were significantly higher than radical nephrectomy patients (97.88, 96.28, 95.09, and 88.58 %, respectively). Cox proportional hazards regression model showed that tumor N stage, signs of lung metastasis (such as cough and hemoptysis), signs of bone metastasis (such as bone pain and fracture), pathological subtype of RCC, microscopic sarcomatoid change, and progression were prognosis factors for Chinese RCC patients. Tumor stage, nephrectomy type, lung metastasis, bone metastasis, pathological subtype, sarcomatoid change, and type of progression were important risk factors for RCC. For T1 stage RCC patients, nephron-sparing nephrectomy showed better CSS than radical nephrectomy, which may guide the doctors and patients in their choices of surgical procedures.

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