Clinical features and prognostic analysis of spontaneous rupture of renal cell carcinoma: a retrospective cohort study

作者：Shanhua Zhang, Xiaoran Han, Shaoqiu Kong, Jianyu Wang, Cheng Wang, Fei Wu, Haihu Wu, Jiaju Lyu, Hao Ning · 发表于：Frontiers in Oncology · 年份：2025 · DOI：10.3389/fonc.2025.1598055 · 研究领域：Renal cell carcinoma treatment、Cancer Research and Treatments、Tuberous Sclerosis Complex Research

Background: Spontaneous rupture of renal cell carcinoma (SRRCC) is a rare but critical clinical manifestation characterized by the acute disruption of tumor integrity, leading to extravasation of tumor contents into the perirenal space and associated complications. Understanding its clinical features, risk factors, and prognosis is essential for optimizing diagnosis and treatment. Methods: This retrospective, single-center study analyzed 37 cases of SRRCC from 165 patients with spontaneous renal tumor rupture treated between April 2014 and June 2024. Clinical, pathological, and laboratory data were collected and analyzed. Kaplan-Meier survival analysis and univariate Cox regression were used to evaluate cancer-specific survival (CSS) and progression-free survival (PFS). Results: The median age of SRRCC patients was 49 years (IQR: 38-60), with males accounting for 59.5%. Tumors were predominantly located in the left kidney (70.3%), with clear cell renal cell carcinoma (ccRCC) being the most common histological subtype (56.8%). The median tumor size was 6.5 cm(IQR: 4.1-10.1). The most frequent symptom was flank or abdominal pain (83.8%). Preoperative laboratory tests showed elevated APTT, PT, D-dimer, and fibrinogen levels. Radical nephrectomy was performed in 64.9% of patients, and 48.6% underwent emergency surgery. The median follow-up duration was 60 months (IQR: 27-80). The median cancer-specific survival (CSS) and progression-free survival (PFS) were 60 months (IQR: 27-80)...