Multivariate analysis of clinicopathologic factors and the efficacy of postoperative IFN-γ adjuvant therapy in 115 patients with renal cell carcinoma

Abstract

Background. In patients with renal cell carcinoma, the relationship between long term survival and clinicopathologic factors is not clear. We performed a retrospective analysis to determine the usefulness of clinicopathological factors as prognostic predictors in these patients and to evaluate the usefulness of interferon-gamma (IFN-γ) adjuvant therapy in their long term survival.

Methods. We performed the analysis in 115 patients with renal cell carcinoma who underwent nephrectomy at our institution, between January 1980 and December 1997.

Results. The median follow-up period was 40 months. The overall survival rates at 1, 5, and 10 years were 92.9%, 77.1%, and 77.1%, respectively. Four of the eight prognostic factors evaluated, including growth type, tumor size, clinical stage, local invasion (capsular invasion and microvascular invasion), histopathological architecture, and histopathological grade, were significant by the log-rank test. Multivariate analysis indicated that both growth type (P = 0.0005) and clinical stage (P = 0.0345) were significant independent prognostic factors. Among the 51 patients with clinical stage more advanced than Robson II, or with local invasion, the 5-year survival rate in those with IFN-γ treatment (n = 35) was 68.5 %, while the rate in those without 1FN-γ treatment (n = 16) was 48% (P = 0.0326).

Conclusion. This analysis showed that tumor growth type and clinical stage were important prognostic factors. As no effective therapies have yet been established for advanced renal cell carcinoma, further investigation is warranted to determine the value of IFN-γ as a basic therapy for advanced renal cell carcinoma and for these carcinomas of the rapid-growth type.