为了评估计算机断层扫描（CT）基于的肾细胞癌（RCC）特征与生存结果之间的关联，我们回顾性评估了2003年6月至2022年3月间接受部分/根治性肾切除术的958例临床T1b-T2 RCC患者的数据。两名放射科医师对患者的CT图像进行了复审，以进行肿瘤异质性的纹理分析和肿瘤轮廓的形状分析。根据CT特征的模式，将患者分为三组：（1）良好特征组（n = 117）；（2）中间特征组（n = 606）；（3）不良特征组（n = 235）。我们使用Kaplan-Meier生存分析和多变量Cox回归分析评估了总生存（Overall survival，OS）、癌特异性生存（Cancer-specific survival，CSS）和无复发生存（Recurrence-free survival，RFS）。根据CT特征，不良特征的RCC在CT上显示出更大的大小，更高的核级别，更高的组织坏死率和更高的包膜侵犯率（所有p <0.001）。不良特征与较差的OS（p = 0.001）、CSS（p <0.001）和RFS（p <0.001）相关。在多变量分析中，中间和不良特征是复发的独立预测因子（风险比[HR] 2.51，95%置信区间[CI] 1.09-5.79，p = 0.031 和 HR 3.71，95% CI 1.58-8.73，p = 0.003），但不是全因死亡或RCC特异性死亡。临床T1b-T2 RCC术前在CT上呈现出不规则肿瘤轮廓特征和异质性肿瘤纹理特征的组合与较差的RFS相关。© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

To evaluate association between computer tomography (CT)-based features of renal cell carcinoma (RCC) and survival outcomes.Data of 958 patients with clinical T1b-T2 RCC who underwent partial/radical nephrectomy from June 2003 to March 2022 were retrospectively evaluated. CT images of patients were reviewed by two radiologists for texture analysis of tumor heterogeneity and shape analysis of tumor contour. Patients were divided into three groups according to patterns of CT-based features: (1) favorable feature group (n = 117); (2) intermediate feature group (n = 606); and (3) unfavorable feature group (n = 235). Kaplan-Meier survival analysis and multivariate Cox regression analysis were performed to evaluate overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS).RCCs with unfavorable CT-based feature showed larger size on CT, higher nuclear grade, higher rate of histologic necrosis, and higher rate of capsular invasion than those in the other two groups (all p < 0.001). Unfavorable feature was associated with poorer OS (p = 0.001), CSS (p < 0.001), and RFS (p < 0.001) on Kaplan-Meier analysis. In multivariate analysis, intermediate and unfavorable features were independent predictors for recurrence (hazard ratio [HR] 2.51, 95% confidence interval [CI] 1.09-5.79, p = 0.031 and HR 3.71, 95% CI 1.58-8.73, p = 0.003, respectively), but not for overall death or RCC-specific death.A combination of irregular tumor contour feature with heterogeneous tumor texture feature on CT is associated with poor RFS in clinical T1b-T2 RCC preoperatively.© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.