基于SEER数据库分析术后放疗等因素对转移性肉瘤样肾细胞癌预后的影响

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Effects of postoperative radiotherapy and other factors on the prognosis of metastatic sarcomatoid renal cell carcinoma based on SEER database

CAI Shengping，YANG Pengcheng，LEI Tianyu，HU Qinyong （Cancer Center，Renmin Hospital，Wuhan University，Wuhan 43Oo6o，China）

ABSTRACT：ObjectiveTo analyze the effects of postoperative radiotherapyand other factors on the prognosis of metastatic sarcomatoid renal cellcarcinoma（sRCC）soas to provide reference for theclinical decision-making.Methods Data of alsRCC patients during 2004—2018 were extracted from the American Surveillnce，Epidemiology，and End Results （SEER）database，and 337 patients were ultimately enrolled.Patients were divided into the postoperative non-radiotheropy group （ n=255 ）and postoperative radiotherapy group（ n=82 ）based on different treatment modalities.Baseline data were compared between the two groups.The1-year overallsurvival（OS）andcancer-specific survival（（CSS）rates werecalculated. Kaplan-Meier（K-M）survivalcurves were ploted.The prognostic factors were identified with univariateand multivariate Cox regression analyses.ResultsNo significant diferences were observed in baseline data between the two groups （ P>0.05 .The 1-year OS （25.6%νs.30.1%） and Css 26.2% vs. 30.8% ） in the postoperative radiotherapy group were lower than those in the postoperative no-radiotheropy group，but the differences were not statistically significant （ P>0.05; .Multivariate Cox regresionanalysisshowedthatyearof diagnosis，patients’age，tumorsize，Tstage，Nstage andchemotherapy were independent prognostic factors of sRCC （ P<0.05; . Patients diagnosed in 2Ol5—2Ol8 and treated with chemotherapy had a good prognosis， while patients >61 years，with tumor size >147mm ，tumor stage T3-T4 ，and stage N1 had a poor prognosis.Conclusion The yearof diagnosis，patients’age，tumor size，tumor stage and chemotherapy were independent prognostic factors，and postoperative radiotherapy did not significantly improve the prognosis of metastatic sRCC patients.

KEY WORDS：postoperative radiotherapy； sarcomatoid renal cell carcinoma； prognosis； metastasis；SEER database

中图分类号：R730.55 文献标志码：A DOI：10.3969/j.issn.1009-8291.2025.08.010

约 5% 的肾细胞癌（renalcell carcinoma，RCC）患者会发生一种比较罕见的肉瘤样去分化表现，称之为肉瘤样肾细胞癌（sarcomatoidrenalcellcarcinoma， sRCC）[1-4] ，其可在RCC的大部分病理类型中出现，病理学特征为上皮细胞与更为恶性的梭形细胞混合存在[5-7]，侵袭性强、预后极差，中位生存期约 6～13 个月[1.5.8]。（剩余9800字）