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lüll Baseline perfusion CT parameters as potential biomarkers in predicting long-term prognosis of localized clear cell renal cell carcinoma Wang Y; Cui L; Zhang J; Zhang L; Zhang J; Zhao X; Chen YAbdom Radiol (NY) 2019[Oct]; 44 (10): 3370-3376PURPOSE: We aimed to explore the relationship among baseline perfusion CT parameters, clinical, and pathological factors with post-nephrectomy long-term progression-free survival in localized clear cell renal cell carcinoma. MATERIALS AND METHODS: This study retrospectively collected 127 patients from March 2005 to May 2007 who undertook perfusion CT. 61 patients were confirmed of pT1N0M0 or pT2N0M0 ccRCC. The mean follow-up time is 118.8 months (+/- 13.1 m, range 72-135 m). We compared clinical, pathological factors (gender, T stage, age, Fuhrmann grade, VEGF level, and MVD), and perfusion parameters before treatment [blood flow (BF), blood volume, mean transition time, and permeability surface-area product] between groups with post-nephrectomy metastasis and without metastasis. Association between covariates and progression-free survival (PFS) were analyzed using Cox proportional regression. RESULTS: Among 61 patients, 11 developed distant metastasis (10 in the lung, one in the bone). BF in metastatic group [429.1 (233.8, 570.1) ml/min/100 g] was significantly higher than non-metastatic group [214.3 (153.3, 376.5) ml/min/100 g] (p = 0.011). Metastatic group also had more patients with higher Fuhrmann grade. Multi-covariant Cox regression demonstrated T staging, Fuhrmann grade, and BF were significantly associated with PFS [hazard ratio (HR) 3.35, 3.08, and 1.006]. In another model, BF > 230 ml/min/100 g was associated with PFS (HR 12.90), along with T staging and Fuhrmann grade (HR 4.73, 3.69). CONCLUSION: Baseline tumor BF is a potential biomarker in prediction long-term metastasis of localized ccRCC and may help screening for higher risk localized ccRCC patients who need personalized surveillance strategy after nephrectomy.|Adult[MESH]|Carcinoma, Renal Cell/*blood supply/*diagnostic imaging/pathology/surgery[MESH]|Disease Progression[MESH]|Female[MESH]|Humans[MESH]|Kidney Neoplasms/*blood supply/*diagnostic imaging/pathology/surgery[MESH]|Male[MESH]|Middle Aged[MESH]|Neoplasm Grading[MESH]|Neoplasm Metastasis[MESH]|Neoplasm Staging[MESH]|Nephrectomy[MESH]|Prognosis[MESH]|Radiographic Image Interpretation, Computer-Assisted[MESH]|Retrospective Studies[MESH]|Tomography, X-Ray Computed/*methods[MESH] |