The Impact of Metastatic Site on Survival in Renal Cell Carcinoma

The Impact of Metastatic Site on Survival in Renal Cell Carcinoma | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article The Impact of Metastatic Site on Survival in Renal Cell Carcinoma Gonca AKDERE ATEŞ, Atike Pınar ERDOĞAN, Fatma CAN, Emine TÜRKMEN, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6991364/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Objective. The aim of this study is to comprehensively analyze the prognostic significance of various clinical and pathological factors, including age, body mass index, Karnofsky performance score, International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, accompanying chronic diseases and sites of metastasis, in determining the risk of mortality among patients with metastatic renal cell carcinoma. Material and Methods . 111 patients with RCC who presented to Manisa Celal Bayar University Research Hospital between 2000 and 2020 were included in the study. The collected data were analyzed retrospectively. Results. Univariate analysis showed a statistically significant reduction in the risk of death for patients with diabetes mellitus and chronic kidney disease. The multivariate analysis indicated a significantly increased risk of death for patients with non-clear cell RCC histology, liver metastasis, or metastases at other sites. Bone metastasis was associated with a decreased risk of death in both univariate and multivariate analyses. No significant association with mortality risk was observed for age, gender, Karnofsky performance score, stage at diagnosis, presence of lung, lymph node, and central nervous system metastases or IMDC risk score. Conclusion. Liver metastasis and metastasis in areas other than lung, bone, CNS, or lymph nodes are associated with an increased risk of death in patients with metastatic renal cell carcinoma. Renal cell carcinoma Prognosis Suvival 1. Introduction Metastatic renal cell carcinoma (mRCC) poses a significant clinical challenge due to its aggressive nature and variable response to systemic therapies; a comprehensive investigation into the factors that predict prognosis in mRCC is essential for informed clinical decision-making, personalized treatment strategies, and improved patient outcomes [1]. The identification and validation of reliable prognostic markers can aid in risk stratification, treatment selection, and the development of novel therapeutic interventions. Several clinicopathological and molecular parameters have been investigated for their prognostic significance in RCC, but few have been successfully validated for widespread clinical use. The evaluation of prognostic factors and long-term survival in mRCC patients is critical, as approximately 20–40% of individuals with localized disease develop metastases after nephrectomy [2]. Conventional clinicopathological factors such as tumor stage, grade, and histology have been shown to be important prognostic indicators [3]. Targeted therapies and immunotherapies have greatly changed how mRCC is treated. This requires improving current ways of predicting outcomes and adding new markers to better predict how patients will respond to treatment and how long they will survive with personalized medicine. [4]. Clinicopathological prognostic factors play a crucial role in determining the outlook for patients with metastatic renal cell carcinoma. A poorer performance status, as reflected by a lower Karnofsky score, is associated with a worse prognosis. Similarly, the presence of anemia, indicated by hemoglobin levels below the normal range, is linked to a poorer outlook [5]. The development of widespread metastatic disease, especially involving multiple anatomical sites, adversely impacts survival. Larger primary tumor size is generally indicative of more advanced disease, and thus is associated with worse outcomes. The presence of systemic symptoms, such as cachexia, also serves as a negative prognostic indicator [6]. Additionally, an elevated platelet count has been linked to a poorer prognosis in this patient population [7]. Pathological factors play a key role in prognosis for renal cell carcinoma. Higher tumor grade and the presence of tumor necrosis indicate more aggressive disease and poorer outcomes. Some histological subtypes, like chromophobe RCC, may have better prognosis compared to clear cell RCC. Sarcomatoid differentiation is a strong predictor of worse prognosis. This study aims to evaluate the prognostic significance of established clinical factors, such as age, body mass index, Karnofsky performance score, and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, along with commonly observed comorbidities like diabetes, chronic kidney disease, and hypertension, in predicting mortality risk among patients with mRCC. Furthermore, this study will investigate the prognostic roles of histological subtypes and metastatic sites in influencing patient survival, aiming to elucidate the heterogeneity and clinical course of metastatic renal cell carcinoma. 2. Material and Methods Patients with RCC who presented to Manisa Celal Bayar University Research Hospital between 2000 and 2021 were included in the study. Body mass index, smoking status, Karnofsky performance score, and the presence of diabetes mellitus, hypertension, chronic kidney disease, chronic heart disease,chronic lung disease and histology, tumour, node, metastasis (TNM) stage, recurrence date and type, site of metastasis and treatment, last date of surveillance or death were recorded from the patients' original medical files. Tumours were staged according to the 2002 TNM classification. Patients were followed up until death or the end of the study period in February 2021. Manisa Celal Bayar University Research Hospital's ethics committee granted approval to collect data for this study. The mean follow-up time was 71 months (range 0 days to 20 years). At the moment of analysis 37% of subjects had died. SPSS 15.0 for Windows was used for statistical analysis. Descriptive statistics were presented as counts and percentages for categorical variables and mean, standard deviation, minimum, maximum, and median for numerical variables. Proportions between groups were compared using the Chi-Square test. Comparisons of numerical variables between groups were performed using Student's t-test when the data met the assumption of normal distribution and the Mann-Whitney U test when the assumption was not met. Relationships between numerical variables were examined using Spearman's Correlation Analysis due to non-parametric data distribution. Determinant factors were investigated with Linear Regression Analysis and Cox Regression Analysis. Survival analysis was performed using Kaplan-Meier Analysis. The alpha level of significance was set at p < 0.05 3. Results 111 patients were included in the study. The study population included 30% female and 70% male participants. The majority of patients, 55%, were 65 years old or younger. The patients' ages ranged from 21 to 82 years, with a mean and median age of 63 years. 48% had a body mass index under 25. Current smokers, former smokers, and never smokers were 32%, 28%, and 40%, respectively. 85% of the patients had a Karnofsky performance score of 70 or greater. The most common comorbidity was hypertension, present in 41% of the patients. At the time of diagnosis, 14% of the patients were in stage 1, 9% in stage 2, 26% in stage 3, and 50% in stage 4. The most common histological type was clear cell, accounting for 73% of cases. 52% of patients had bone metastases ,67% lung metastases, 34% liver metastases, 68% lymph node metastases, 9% brain metastases and %40 other sites metastases. According to the univariate analysis, the risk of death was significantly reduced in patients with diabetes mellitus (HR: 0.39; 95% CI: 0.16-0.93, p=0.03) and chronic kidney disease (HR: 0.29; 95% CI: 0.09-0.95, p=0.043). In the multivariate subgroup analysis, the risk of death was significantly increased in histological types other than clear cell RCC (HR: 2.36; 95% CI: 1.19-4.69, p=0.014). Both univariate and multivariate analyses showed a significantly increased risk of death in the following situations: Liver metastasis (Univariate HR: 1.86, 95% CI: 1.02-3.43, p=0.045; Multivariate HR: 2.11, 95% CI: 1.1-4.07, p=0.025), metastasis in areas other than specified regions (Univariate HR: 2.75, 95% CI: 1.48-5.09, p=0.001; Multivariate HR: 2.33, 95% CI: 1.15-4.70, p=0.018). Bone metastasis was associated with a decreased risk of death according to both univariate and multivariate analyses (Univariate HR: 0.48, 95% CI: 0.26-0.88, p=0.019; Multivariate HR: 0.38, 95% CI: 0.19-0.78, p=0.025). No association was found between age, gender, Karnofsky performance score, stage at diagnosis, and IMDC risk score and the risk of death. Table 1. Patients Demographics Mean and median age (min‑max) 63,5±10,6 (21-82) Age ≤65 61 (55 %) >65 50 (45 %) Sex Female 33 (29,7%) Male 78 (70,3%) Mean and median BMI (min-max) 25,5±3,5 (16,7-33,4) BMI <25 53 (47,7%) ≥25 58 (52,3%) S moking Current 36 (32,4%) Smoking-Former 31 (27,9%) Smoking-Never 44 (39,6%) Karnofsky <% 70 17 (15,3%) ≥% 70 94 (84,7%) Diabetes Mellitus 27 (24,3%) Hypertension 46 (41,4%) Chronic Kidney Disease 22 (19,8%) Chronic Cardiac Disease 20 (18%) Chronic Lung Disease 14 (12,6%) Stage at Diagnosi s Stage 1 16 (14,4%) Stage 2 10 (9%) Stage 3 29 (26,1%) Stage 4 56 (50,5%) H istological Type Clear cell 81 (73,0%) Other 30 (27,0%) I MDC risk score Favorable 9 (8,1%) Intermediate 68 (61,3%) Poor 34 (30,6%) Metastasis sites Liver 38 (34,2%) Lung 74 (66,7%) Bone 58 (52,3%) Central nervous system 10 (9,0%) Lymph node 76 (68,5%) Other sites 45 (40,5%) Follow-up Time (months ) Median (Min-Max) 71 (0-248) Table 2 . Demographic and Disease Characteristics of Surviving and Deceased Patients Survived Deceased Mean and median age (min‑max) 63,1±11,7 (21-82) 64,0±8,5 (47-78) 0,668* Age 65 yaş ve altı 38 (55,1) 23 (54,8) 0,975 # >65 yaş 31 (44,9) 19 (45,2) Sex Female 19 (27,5) 14 (33,3) 0,517 # Male 50 (72,5) 28 (66,7) BMI (m ean and median) 25,5±3,5 (16,7-33,4) 25,5±3,5 (17,3-32) 0,942* BMI <25 34 (49,3) 19 (45,2) 0,680* ≥25 35 (50,7) 23 (54,8) S moking Current 26 (37,7) 10 (23,8) 0,316 Smoking-Former 18 (26,1) 13 (31,0) Smoking-Never 25 (36,2) 19 (45,2) Karnofsky <% 70 10 (14,5) 7 (16,7) 0,758 ≥% 70 59 (85,5) 35 (83,3) Diabetes Mellitus 21 (30,4) 6 (14,3) 0,054 Hypertension 31 (44,9) 15 (35,7) 0,339 Chronic Kidney Disease 19 (27,5) 3 (7,1) 0,009 Chronic Cardiac Disease 13 (18,8) 7 (16,7) 0,773 Chronic Lung Disease 9 (13,0) 5 (11,9) 0,861 Stage at Diagnosi s Stage 1 11 (15,9) 5 (11,9) 0,015 Stage 2 9 (13,0) 1 (2,4) Stage 3 22 (31,9) 7 (16,7) Stage 4 27 (39,1) 29 (69,0) H istological Type Clear cell 53 (76,8) 28 (66,7) 0,243 Other 16 (23,2) 14 (33,3) I MDC risk score Favorable 7 (10,1) 2 (4,8) 0,509 Intermediate 40 (58,0) 28 (66,7) Poor 22 (31,9) 12 (28,6) Metastasis sites Liver 19 (27,5) 19 (45,2) 0,057 Lung 44 (63,8) 30 (71,4) 0,406 Bone 41 (59,4) 17 (40,5) 0,053 Central nervous system 5 (7,2) 5 (11,9) 0,499 Lymph node 44 (63,8) 32 (76,2) 0,172 Other sites 21 (30,4) 24 (57,1) 0,005 Follow-up Time (months) Median (Min-Ma x ) 177 (3-248) 9 (0-154) <0,001 *Student t Test **Mann Whitney U test #Chi Square Test Table 3 . Univariate and multivariate Cox Regression Analysis of patient characteristics for mortality Univariate M ultivariate* HR (95% CI) p HR (95% CI) p Age ≤65 1 0,948 >65 1,020 (0,556-1,874) Sex Female 1 0,830 Male 1,069 (0,582-1,965) D iabetes Mellitus No 1 0,033 1 0,059 Yes 0,390 (0,164-0,926) 0,392 (0,148-1,037) Hypertension No 1 0,097 1 0,749 Yes 0,584 (0,310-1,102) 0,881 (0,404-1,920) Chronic Kidney Disease No 1 0,043 1 0,077 Yes 0,297 (0,092-0,952) 0,426 (0,123-1,469) Chronic Cardiac Disease No 1 0,666 Yes 0,836 (0,371-1,884) Chronic Lung Disease No 1 0,678 Yes 0,821 (0,322-2,089) Karnofsky ≥% 70 1 0,624 <% 70 1,225 (0,544-2,761) Stage at Diagnosis I 1 1 II 0,262 (0,031-2,245) 0,222 0,125 (0,013-1,172) 0,069 III 0,691 (0,219-2,179) 0,528 0,462 (0,133-1,605) 0,224 IV 2,211 (0,854-5,721) 0,102 1,758 (0,649-4,764) 0,267 H istological Type Clear cell 1 0,155 1 0,014 Other 1,594 (0,838-3,030) 2,363 (1,191-4,689) I MDC Risk Favorable 1 Intermediate 2,244 (0,534-9,423) 0,270 Poor 1,869 (0,418-8,355) 0,413 Metastasis sites Liver No 1 0,045 1 0,025 Yes 1,865 (1,015-3,426) 2,114 (1,097-4,073) Lung No 1 0,363 Yes 1,365 (0,699-2,667) Bone No 1 0,019 1 0,008 Yes 0,477 (0,257-0,885) 0,383 (0,189-0,777) Central nervous system No 1 0,692 Yes 1,208 (0,474-3,076) L ymph node No 1 0,151 1 0,487 Yes 1,683 (0,827-3,427) 1,310 (0,611-2,809) Other sites No 1 0,001 0,018 Yes 2,750 (1,484-5,096) 2,329 (1,154-4,700) *Variables with p<0.250 in univariate analyses included in the multivariate model 4. Discussion A significant number of clinical and molecular factors have been suggested as prognostic or predictive indicators for patients with renal cell carcinoma, but none have been adequately validated. Several studies have shown the important prognostic factors in patients with metastatic RCC. Age, gender, stage, BMI, smoking status and symptoms were analyzed. Cachexia predicts poorer survival. The European Association of Urology risk groups included Karnofsky performance status, hemoglobin, time from diagnosis to systemic therapy, corrected calcium, neutrophils and platelets, but many other clinicopathological parameters have also been evaluated. In the present study, we found that according to the univariate analysis,the presence of diabetes or chronic kidney disease was associated with a reduced risk of death in patients with RCC. In the multivariate subgroup analysis, the risk of death was significantly increased in histological types other than clear cell RCC. Both univariate and multivariate analyses showed a significantly increased risk of death in liver metastasis and metastasis in areas other than lung, bone, CNS or lymph nodes. Bone metastasis was associated a decreased risk of death according to both univariate and multivariate analyses. A retrospective study also revealed that, among patients with RCC, the subgroup with liver metastases exhibited the worst prognosis, while the subgroup with bone metastases had the most favorable prognosis[8]. Several potential explanations may account for this observation, such as variations in tumor biology depending on the site of metastatic spread. A study of triple-negative metastatic breast cancer patients revealed that bone, lung, and liver metastases were associated with a more favorable prognosis compared to brain metastasis[9]. In our study, there was no significant difference in overall survival between patients with and without central nervous system metastases. Conversely, another study indicated that in patients with metastatic gastric cancer, liver or lung metastases were associated with a favorable prognosis, while bone metastasis was associated with a poor prognosis[10]. A study concerning non-small cell lung cancer indicated that patients with liver and multi-organ metastases exhibited the poorest prognosis [11]. These results indicate that in addition to the primary tumor type, the pattern of metastatic spread is also a significant predictor of survival. Our study’s findings align with the existing literature, indicating that distant metastasis sites can significantly affect survival rates in individuals with metastatic RCC. Therefore, evaluating the location of metastases in patients with RCC is crucial for developing individualized treatment strategies and improving overall outcomes. 5. Limitations of the Study Given its retrospective design, the study is inherently susceptible to biases stemming from its reliance on pre-existing data, including selection and information biases. Our study is based on data from a single institution, Manisa Celal Bayar University Research Hospital. This represents a limitation in generalizing the study's results to broader patient populations and diverse healthcare environments. Variations in treatment regimens among the study participants may have influenced the observed outcomes, as detailed data on specific systemic treatments were not available. The current study indicates that metastasis outside of the typical locations has a notable effect on survival outcomes; however, the specific sites involved were not individually characterized. Future research should aim to identify the differential impacts of particular metastatic sites within this collective group. 6. Conclusion In conclusion, our findings indicate that liver metastasis, along with metastasis in regions other than the lung, bone, central nervous system, or lymph nodes, correlates with a heightened mortality risk in individuals with metastatic renal cell carcinoma. Conversely, the presence of bone metastasis is associated with a reduced risk of death. Declarations Authors’ Contribution: GAA: Concept, supervision, materials, analysis, interpretation, literature search and writing manuscript. APE, FC, MŞ: Data collection, processing, analysis and interpretation. ET: Data collection and processing. FE: Supervision, literature search and critical review. Funding: No funding was received. Clinical Trial Number : Not applicable. Data availability Data is provided within the manuscript or supplementary information files. Ethics approval and consent to participate The Helsinki Declaration of 1964, its later updates, and comparable ethical principles, as well as institutional and national bodies’ ethical standards, were all followed in the research involving human subjects. The Health Sciences Ethics Committee approved this study of Manisa Celal Bayar University Faculty of Medicine with the decision dated 01/07/2020 and No. 20.478.486/050 Informed Consent statement Informed consent was obtained from all participants involved in the study and from parents/legal guardians of deceased participants. Consent for publication All authors agreed to publish. Competing interests The authors declare no competing interests. References R. M. Ali et al., “Prognostic factors in renal cell carcinoma: A single‑center study,” Molecular and Clinical Oncology, vol. 19, no. 3, Jul. 2023, doi: 10.3892/mco.2023.2662. K. Sunela et al., “Prognostic factors and long-term survival in renal cell cancer patients,” Scandinavian Journal of Urology and Nephrology, vol. 43, no. 6, p. 454, Dec. 2009, doi: 10.3109/00365590903286697. A. Volpe and J. J. Patard, “Prognostic factors in renal cell carcinoma,” World Journal of Urology, vol. 28, no. 3. Springer Science+Business Media, p. 319, Apr. 02, 2010. doi: 10.1007/s00345-010-0540-8. A. S. Belldegrun, “Renal Cell Carcinoma: Prognostic Factors and Patient Selection,” European Urology Supplements, vol. 6, no. 7, p. 477, Feb. 2007, doi: 10.1016/j.eursup.2007.01.016. R. J. Motzer et al., “Prognostic Factors for Survival in Previously Treated Patients With Metastatic Renal Cell Carcinoma,” Journal of Clinical Oncology, vol. 22, no. 3, p. 454, Jan. 2004, doi: 10.1200/jco.2004.06.132. H. L. Kim et al., “Paraneoplastic Signs and Symptoms of Renal Cell Carcinoma: Implications for Prognosis,” The Journal of Urology, vol. 170, no. 5, p. 1742, Nov. 2003, doi: 10.1097/01.ju.0000092764.81308.6a. N. P. Symbas, M. F. Townsend, R. El-Galley, T. E. Keane, S. D. Graham, and J. A. Petros, “Poor prognosis associated with thrombocytosis in patients with renal cell carcinoma,” BJU International, vol. 86, no. 3, p. 203, Aug. 2000, doi: 10.1046/j.1464-410x.2000.00792.x. O. Abdel‐Rahman, “Clinical correlates and prognostic value of different metastatic sites in metastatic renal cell carcinoma,” Future Oncology, vol. 13, no. 22, p. 1967, Aug. 2017, doi: 10.2217/fon-2017-0175. Y. Gu, G. Wu, X. Zou, P. Huang, and L. Yi, “Prognostic Value of Site-Specific Metastases and Surgery in De Novo Stage IV Triple-Negative Breast Cancer: A Population-Based Analysis,” Medical Science Monitor, vol. 26, Jan. 2020, doi: 10.12659/msm.920432. M. Qiu et al., “Frequency and clinicopathological features of metastasis to liver, lung, bone, and brain from gastric cancer: A SEER‐based study,” Cancer Medicine, vol. 7, no. 8, p. 3662, Jul. 2018, doi: 10.1002/cam4.1661. J. Yang et al., “The prognostic value of multiorgan metastases in patients with non-small cell lung cancer and its variants: a SEER-based study,” Journal of Cancer Research and Clinical Oncology, vol. 144, no. 9, p. 1835, Jul. 2018, doi: 10.1007/s00432-018-2702-9. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6991364","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":491462265,"identity":"2e7bbc8c-b5a5-4913-9f6c-424e90d0acfa","order_by":0,"name":"Gonca AKDERE ATEŞ","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA/UlEQVRIiWNgGAWjYBADA4YDQPJjA4jN2HiAaC2MMxsYJIBUA/FamHnBWhgY8GqRd+89+OEHg50x3/Heh49td9jU6bYfBtpSYxONS4vhmXPJkj0MyWaSZ44bG+eeSZMwO5MI1HIsLbcBl5YZOWYMPAzMNgY30tikc9sOS5gdAGphbDiMVwvjH4Z6G4P7z9h/W4K0nH+IX4u8RI4ZMw/DYTODG2xszIwgLTcI2GLAc8ZYWobhuLHkmTRmyd62NMltN4C2JODxi3x7j+HHNwzVhn3HjzF++Nlmw292Pv3hgw81NrhtOQAkGP+hCyfgUA62BZdZo2AUjIJRMArgAACzvl8bA+wSmgAAAABJRU5ErkJggg==","orcid":"","institution":"Sinop Atatürk State Hospital","correspondingAuthor":true,"prefix":"","firstName":"Gonca","middleName":"AKDERE","lastName":"ATEŞ","suffix":""},{"id":491462266,"identity":"0936f66c-80f6-4d33-9a71-aab38dd428a0","order_by":1,"name":"Atike Pınar ERDOĞAN","email":"","orcid":"","institution":"Manisa Celal Bayar University","correspondingAuthor":false,"prefix":"","firstName":"Atike","middleName":"Pınar","lastName":"ERDOĞAN","suffix":""},{"id":491462267,"identity":"b127e98b-b2c0-4369-bf67-bb33442852d7","order_by":2,"name":"Fatma CAN","email":"","orcid":"","institution":"Manisa Celal Bayar University","correspondingAuthor":false,"prefix":"","firstName":"Fatma","middleName":"","lastName":"CAN","suffix":""},{"id":491462268,"identity":"573be689-4a45-4030-bd06-2d32e599a602","order_by":3,"name":"Emine TÜRKMEN","email":"","orcid":"","institution":"Manisa Celal Bayar University","correspondingAuthor":false,"prefix":"","firstName":"Emine","middleName":"","lastName":"TÜRKMEN","suffix":""},{"id":491462269,"identity":"d6b1b6a9-b75c-4e93-9172-768144226a1f","order_by":4,"name":"Mustafa ŞAHBAZLAR","email":"","orcid":"","institution":"Manisa Celal Bayar University","correspondingAuthor":false,"prefix":"","firstName":"Mustafa","middleName":"","lastName":"ŞAHBAZLAR","suffix":""},{"id":491462270,"identity":"1819792a-d4fd-43ad-8bfe-c413d8ff173f","order_by":5,"name":"Ferhat EKİNCİ","email":"","orcid":"","institution":"Manisa Celal Bayar University","correspondingAuthor":false,"prefix":"","firstName":"Ferhat","middleName":"","lastName":"EKİNCİ","suffix":""}],"badges":[],"createdAt":"2025-06-27 11:53:28","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6991364/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6991364/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":91616800,"identity":"5a91d24b-df24-4226-bf44-8324e0c81b7e","added_by":"auto","created_at":"2025-09-18 10:40:33","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1079099,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6991364/v1/cd662c2c-472e-4cb9-b836-b8704a12642f.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The Impact of Metastatic Site on Survival in Renal Cell Carcinoma","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eMetastatic renal cell carcinoma (mRCC) poses a significant clinical challenge due to its aggressive nature and variable response to systemic therapies; a comprehensive investigation into the factors that predict prognosis in mRCC is essential for informed clinical decision-making, personalized treatment strategies, and improved patient outcomes [1]. The identification and validation of reliable prognostic markers can aid in risk stratification, treatment selection, and the development of novel therapeutic interventions. Several clinicopathological and molecular parameters have been investigated for their prognostic significance in RCC, but few have been successfully validated for widespread clinical use.\u003c/p\u003e\u003cp\u003eThe evaluation of prognostic factors and long-term survival in mRCC patients is critical, as approximately 20\u0026ndash;40% of individuals with localized disease develop metastases after nephrectomy [2]. Conventional clinicopathological factors such as tumor stage, grade, and histology have been shown to be important prognostic indicators [3]. Targeted therapies and immunotherapies have greatly changed how mRCC is treated. This requires improving current ways of predicting outcomes and adding new markers to better predict how patients will respond to treatment and how long they will survive with personalized medicine. [4].\u003c/p\u003e\u003cp\u003eClinicopathological prognostic factors play a crucial role in determining the outlook for patients with metastatic renal cell carcinoma. A poorer performance status, as reflected by a lower Karnofsky score, is associated with a worse prognosis. Similarly, the presence of anemia, indicated by hemoglobin levels below the normal range, is linked to a poorer outlook [5]. The development of widespread metastatic disease, especially involving multiple anatomical sites, adversely impacts survival. Larger primary tumor size is generally indicative of more advanced disease, and thus is associated with worse outcomes. The presence of systemic symptoms, such as cachexia, also serves as a negative prognostic indicator [6]. Additionally, an elevated platelet count has been linked to a poorer prognosis in this patient population [7].\u003c/p\u003e\u003cp\u003ePathological factors play a key role in prognosis for renal cell carcinoma. Higher tumor grade and the presence of tumor necrosis indicate more aggressive disease and poorer outcomes. Some histological subtypes, like chromophobe RCC, may have better prognosis compared to clear cell RCC. Sarcomatoid differentiation is a strong predictor of worse prognosis.\u003c/p\u003e\u003cp\u003eThis study aims to evaluate the prognostic significance of established clinical factors, such as age, body mass index, Karnofsky performance score, and International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, along with commonly observed comorbidities like diabetes, chronic kidney disease, and hypertension, in predicting mortality risk among patients with mRCC. Furthermore, this study will investigate the prognostic roles of histological subtypes and metastatic sites in influencing patient survival, aiming to elucidate the heterogeneity and clinical course of metastatic renal cell carcinoma.\u003c/p\u003e"},{"header":"2. Material and Methods","content":"\u003cp\u003ePatients with RCC who presented to Manisa Celal Bayar University Research Hospital between 2000 and 2021 were included in the study. Body mass index, smoking status, Karnofsky performance score, and the presence of diabetes mellitus, hypertension, chronic kidney disease, chronic heart disease,chronic lung disease and histology, tumour, node, metastasis (TNM) stage, recurrence date and type, site of metastasis and treatment, last date of surveillance or death were recorded from the patients' original medical files. Tumours were staged according to the 2002 TNM classification.\u003c/p\u003e\u003cp\u003ePatients were followed up until death or the end of the study period in February 2021. Manisa Celal Bayar University Research Hospital's ethics committee granted approval to collect data for this study.\u003c/p\u003e\u003cp\u003eThe mean follow-up time was 71 months (range 0 days to 20 years). At the moment of analysis 37% of subjects had died.\u003c/p\u003e\u003cp\u003eSPSS 15.0 for Windows was used for statistical analysis. Descriptive statistics were presented as counts and percentages for categorical variables and mean, standard deviation, minimum, maximum, and median for numerical variables. Proportions between groups were compared using the Chi-Square test. Comparisons of numerical variables between groups were performed using Student's t-test when the data met the assumption of normal distribution and the Mann-Whitney U test when the assumption was not met. Relationships between numerical variables were examined using Spearman's Correlation Analysis due to non-parametric data distribution. Determinant factors were investigated with Linear Regression Analysis and Cox Regression Analysis. Survival analysis was performed using Kaplan-Meier Analysis. The alpha level of significance was set at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e111 patients were included in the study. The study population included 30% female and 70% male participants. The majority of patients, 55%, were 65 years old or younger. The patients\u0026apos; ages ranged from 21 to 82 years, with a mean and median age of 63 years. 48% had a body mass index under 25. Current smokers, former smokers, and never smokers were 32%, 28%, and 40%, respectively. 85% of the patients had a Karnofsky performance score of 70 or greater. The most common comorbidity was hypertension, present in 41% of the patients. At the time of diagnosis, 14% of the patients were in stage 1, 9% in stage 2, 26% in stage 3, and 50% in stage 4. The most common histological type was clear cell, accounting for 73% of cases. 52% of patients had bone metastases ,67% lung metastases, 34% liver metastases, 68% lymph node metastases, 9% brain metastases and %40 other sites metastases.\u003c/p\u003e\n\u003cp\u003eAccording to the univariate analysis, the risk of death was significantly reduced in patients with diabetes mellitus (HR: 0.39; 95% CI: 0.16-0.93, p=0.03) and chronic kidney disease (HR: 0.29; 95% CI: 0.09-0.95, p=0.043). In the multivariate subgroup analysis, the risk of death was significantly increased in histological types other than clear cell RCC (HR: 2.36; 95% CI: 1.19-4.69, p=0.014). Both univariate and multivariate analyses showed a significantly increased risk of death in the following situations: Liver metastasis (Univariate HR: 1.86, 95% CI: 1.02-3.43, p=0.045; Multivariate HR: 2.11, 95% CI: 1.1-4.07, p=0.025), metastasis in areas other than specified regions (Univariate HR: 2.75, 95% CI: 1.48-5.09, p=0.001; Multivariate HR: 2.33, 95% CI: 1.15-4.70, p=0.018). Bone metastasis was associated with a decreased risk of death according to both univariate and multivariate analyses (Univariate HR: 0.48, 95% CI: 0.26-0.88, p=0.019; Multivariate HR: 0.38, 95% CI: 0.19-0.78, p=0.025). No association was found between age, gender, Karnofsky performance score, stage at diagnosis, and IMDC risk score and the risk of death.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable 1. Patients Demographics\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"82%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean and median age (min‑max)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e63,5\u0026plusmn;10,6 (21-82)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e\u0026le;65\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e61 (55 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e\u0026gt;65\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e50 (45 %)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e33 (29,7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e78 (70,3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMean and median BMI\u003c/strong\u003e \u003cstrong\u003e(min-max)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e25,5\u0026plusmn;3,5 (16,7-33,4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBMI\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e\u0026lt;25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e53 (47,7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e\u0026ge;25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e58 (52,3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eS\u003c/strong\u003e\u003cstrong\u003emoking\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eCurrent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e36 (32,4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eSmoking-Former\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e31 (27,9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eSmoking-Never\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e44 (39,6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKarnofsky\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e\u0026lt;% 70\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e17 (15,3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003e\u0026ge;% 70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e94 (84,7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDiabetes Mellitus\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e27 (24,3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHypertension\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e46 (41,4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic Kidney Disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e22 (19,8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic Cardiac Disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e20 (18%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eChronic\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eLung\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Disease\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e14 (12,6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStage at Diagnosi\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eStage 1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e16 (14,4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eStage 2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e10 (9%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eStage 3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e29 (26,1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eStage 4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e56 (50,5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eH\u003c/strong\u003e\u003cstrong\u003eistological Type\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eClear cell\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e81 (73,0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eOther\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e30 (27,0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width: 28px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eI\u003c/strong\u003e\u003cstrong\u003eMDC risk\u003c/strong\u003e \u003cstrong\u003escore\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eFavorable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e9 (8,1%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003eIntermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e68 (61,3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 31px;\"\u003e\n \u003cp\u003ePoor\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e34 (30,6%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMetastasis sites\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLiver\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e38 (34,2%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLung\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e74 (66,7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBone\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e58 (52,3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eCentral nervous system\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e10 (9,0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLymph node\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e76 (68,5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOther sites\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e45 (40,5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width: 60px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow-up Time (months\u003c/strong\u003e\u003cstrong\u003e)\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eMedian (Min-Max)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 39px;\"\u003e\n \u003cp\u003e71 (0-248)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cu\u003e2\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cu\u003e. Demographic and Disease Characteristics of Surviving and Deceased Patients\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width:100.0%;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border-top:solid windowtext 2.25pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width:31.74%;border-top:solid windowtext 2.25pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eSurvived \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Deceased\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border-top:solid windowtext 2.25pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMean and median age (min‑max)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e63,1\u0026plusmn;11,7\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e(21-82)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e64,0\u0026plusmn;8,5\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e(47-78)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,668*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAge\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e65 yaş ve altı\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e38 (55,1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e23 (54,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:10.3%;border:none;border-bottom: solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,975\u003cstrong\u003e\u003csup\u003e#\u003c/sup\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026gt;65 yaş\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e31 (44,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (45,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eSex\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eFemale\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (27,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e14 (33,3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:10.3%;border:none;border-bottom: solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,517\u003cstrong\u003e\u003csup\u003e#\u003c/sup\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMale\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e50 (72,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e28 (66,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eBMI \u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;(m\u003c/span\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eean and median)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e25,5\u0026plusmn;3,5 (16,7-33,4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e25,5\u0026plusmn;3,5\u003c/span\u003e\u003c/p\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e(17,3-32)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,942*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eBMI\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;25\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e34 (49,3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (45,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:10.3%;border:none;border-bottom: solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,680*\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026ge;25\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e35 (50,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e23 (54,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eS\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003emoking\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eCurrent\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e26 (37,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e10 (23,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\" style=\"width:10.3%;border:none;border-bottom: solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,316\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eSmoking-Former\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e18 (26,1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e13 (31,0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eSmoking-Never\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e25 (36,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (45,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eKarnofsky\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;% 70\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e10 (14,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e7 (16,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,758\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026ge;% 70\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e59 (85,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e35 (83,3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eDiabetes Mellitus\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e21 (30,4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e6 (14,3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,054\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eHypertension\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e31 (44,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e15 (35,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,339\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eChronic Kidney Disease\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (27,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e3 (7,1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,009\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eChronic Cardiac Disease\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e13 (18,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e7 (16,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,773\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eChronic \u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eLung\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e Disease\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e9 (13,0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5 (11,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,861\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:10.0pt;'\u003e\u003cstrong\u003eStage at Diagnosi\u003c/strong\u003e\u003cstrong\u003es\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eStage 1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e11 (15,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5 (11,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"4\" style=\"width:10.3%;border:none;border-bottom: solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,015\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eStage 2\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e9 (13,0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1 (2,4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eStage 3\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e22 (31,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e7 (16,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eStage 4\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e27 (39,1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e29 (69,0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eH\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eistological Type\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eClear cell\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e53 (76,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e28 (66,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,243\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eOther\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e16 (23,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e14 (33,3)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"3\" style=\"width:27.64%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eI\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMDC risk\u003c/span\u003e\u003c/strong\u003e\u003cspan style='font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003escore\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eFavorable\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e7 (10,1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2 (4,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,509\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:115%;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:10.0pt;'\u003eIntermediate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e40 (58,0)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e28 (66,7)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width:30.28%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003ePoor\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e22 (31,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e12 (28,6)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMetastasis sites\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eLiver\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (27,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e19 (45,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,057\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eLung\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e44 (63,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e30 (71,4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,406\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eBone\u0026nbsp;\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e41 (59,4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e17 (40,5)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,053\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eCentral nervous system\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5 (7,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e5 (11,9)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,499\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eLymph node\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e44 (63,8)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e32 (76,2)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,172\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eOther sites\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e21 (30,4)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e24 (57,1)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,005\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"2\" style=\"width:57.92%;border:none;border-bottom:solid windowtext 2.25pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eFollow-up Time (months) Median (Min-Ma\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003ex\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:16.5%;border:none;border-bottom:solid windowtext 2.25pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e177 (3-248)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:15.24%;border:none;border-bottom:solid windowtext 2.25pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e9 (0-154)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:10.3%;border:none;border-bottom:solid windowtext 2.25pt;padding:0cm 3.5pt 0cm 3.5pt;height:19.85pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e\u0026lt;0,001\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e*Student t Test **Mann Whitney U test #Chi Square Test\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u003cu\u003eTable\u0026nbsp;\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cu\u003e3\u003c/u\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cu\u003e. Univariate and multivariate Cox Regression Analysis of patient characteristics for mortality\u003c/u\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003ctable style=\"width:464.2pt;border-collapse:collapse;border:none;\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-width: 2.25pt 1pt 1pt;border-style: solid;border-color: windowtext;border-image: initial;padding: 0cm 3.5pt;height: 17pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:13px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top: 2.25pt solid windowtext;border-left: none;border-bottom: 1pt solid windowtext;border-right: 1pt solid windowtext;padding: 0cm 3.5pt;height: 17pt;vertical-align: bottom;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:13px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"border-top:solid windowtext 2.25pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eUnivariate\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:solid windowtext 2.25pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eM\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eultivariate*\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:solid windowtext 2.25pt;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New 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style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:13px;font-family:\"Arial\",sans-serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eHR (95% CI)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003ep\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eHR (95% CI)\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003ep\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eAge\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026le;65\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,948\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026gt;65\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,020 (0,556-1,874)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eSex\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eFemale\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,830\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eMale\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,069 (0,582-1,965)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eD\u003c/span\u003e\u003c/strong\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eiabetes Mellitus\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eNo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,033\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:42.5pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,059\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eYes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,390 (0,164-0,926)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,392 (0,148-1,037)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eHypertension\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eNo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,097\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:42.5pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,749\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eYes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,584 (0,310-1,102)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,881 (0,404-1,920)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eChronic Kidney Disease\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eNo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,043\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:42.5pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,077\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eYes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,297 (0,092-0,952)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,426 (0,123-1,469)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eChronic Cardiac Disease\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eNo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,666\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eYes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,836 (0,371-1,884)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eChronic Lung Disease\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eNo\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp 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style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"border:solid windowtext 1.0pt;border-top:none;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eKarnofsky\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026ge;% 70\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,624\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026lt;% 70\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1,225 (0,544-2,761)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border-top:none;border-left:none;border-bottom:solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border-top:none;border-left:none;border-bottom: solid windowtext 1.0pt;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"4\" style=\"border:solid windowtext 1.0pt;border-top:none;padding: 0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eStage at Diagnosis\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eI\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e1\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eII\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,262 (0,031-2,245)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,222\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;text-align:center;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,125 (0,013-1,172)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:42.5pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;text-align:center;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e0,069\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp 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style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,001\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width:42.5pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cstrong\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;color:red;'\u003e0,018\u003c/span\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003eYes\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,750 (1,484-5,096)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width:105.3pt;border:none;border-right:solid windowtext 1.0pt;padding:0cm 3.5pt 0cm 3.5pt;height:17.0pt;\"\u003e\n \u003cp style='margin-right:0cm;margin-left:0cm;line-height:normal;font-size:15px;font-family:\"Calibri\",sans-serif;margin-top:0cm;margin-bottom:0cm;'\u003e\u003cspan style='font-size:16px;font-family:\"Times New Roman\",serif;'\u003e2,329 (1,154-4,700)\u003c/span\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cstrong\u003e*Variables with p\u0026lt;0.250 in univariate analyses included in the multivariate model\u003c/strong\u003e\u003c/p\u003e"},{"header":"4. Discussion","content":"\u003cp\u003eA significant number of clinical and molecular factors have been suggested as prognostic or predictive indicators for patients with renal cell carcinoma, but none have been adequately validated. Several studies have shown the important prognostic factors in patients with metastatic RCC. Age, gender, stage, BMI, smoking status and symptoms were analyzed. Cachexia predicts poorer survival. The European Association of Urology risk groups included Karnofsky performance status, hemoglobin, time from diagnosis to systemic therapy, corrected calcium, neutrophils and platelets, but many other clinicopathological parameters have also been evaluated.\u003c/p\u003e\u003cp\u003eIn the present study, we found that according to the univariate analysis,the presence of diabetes or chronic kidney disease was associated with a reduced risk of death in patients with RCC. In the multivariate subgroup analysis, the risk of death was significantly increased in histological types other than clear cell RCC. Both univariate and multivariate analyses showed a significantly increased risk of death in liver metastasis and metastasis in areas other than lung, bone, CNS or lymph nodes. Bone metastasis was associated a decreased risk of death according to both univariate and multivariate analyses.\u003c/p\u003e\u003cp\u003eA retrospective study also revealed that, among patients with RCC, the subgroup with liver metastases exhibited the worst prognosis, while the subgroup with bone metastases had the most favorable prognosis[8]. Several potential explanations may account for this observation, such as variations in tumor biology depending on the site of metastatic spread.\u003c/p\u003e\u003cp\u003eA study of triple-negative metastatic breast cancer patients revealed that bone, lung, and liver metastases were associated with a more favorable prognosis compared to brain metastasis[9]. In our study, there was no significant difference in overall survival between patients with and without central nervous system metastases. Conversely, another study indicated that in patients with metastatic gastric cancer, liver or lung metastases were associated with a favorable prognosis, while bone metastasis was associated with a poor prognosis[10]. A study concerning non-small cell lung cancer indicated that patients with liver and multi-organ metastases exhibited the poorest prognosis [11].\u003c/p\u003e\u003cp\u003eThese results indicate that in addition to the primary tumor type, the pattern of metastatic spread is also a significant predictor of survival. Our study\u0026rsquo;s findings align with the existing literature, indicating that distant metastasis sites can significantly affect survival rates in individuals with metastatic RCC. Therefore, evaluating the location of metastases in patients with RCC is crucial for developing individualized treatment strategies and improving overall outcomes.\u003c/p\u003e"},{"header":"5. Limitations of the Study","content":"\u003cp\u003eGiven its retrospective design, the study is inherently susceptible to biases stemming from its reliance on pre-existing data, including selection and information biases. Our study is based on data from a single institution, Manisa Celal Bayar University Research Hospital. This represents a limitation in generalizing the study's results to broader patient populations and diverse healthcare environments.\u003c/p\u003e\u003cp\u003eVariations in treatment regimens among the study participants may have influenced the observed outcomes, as detailed data on specific systemic treatments were not available.\u003c/p\u003e\u003cp\u003eThe current study indicates that metastasis outside of the typical locations has a notable effect on survival outcomes; however, the specific sites involved were not individually characterized. Future research should aim to identify the differential impacts of particular metastatic sites within this collective group.\u003c/p\u003e"},{"header":"6. Conclusion","content":"\u003cp\u003eIn conclusion, our findings indicate that liver metastasis, along with metastasis in regions other than the lung, bone, central nervous system, or lymph nodes, correlates with a heightened mortality risk in individuals with metastatic renal cell carcinoma. Conversely, the presence of bone metastasis is associated with a reduced risk of death.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; Contribution:\u0026nbsp;\u003c/strong\u003eGAA: Concept, supervision, materials, analysis, interpretation, literature search and writing manuscript. APE, FC, MŞ: Data collection, processing, analysis and interpretation. ET: Data collection and processing. FE: Supervision, literature search and critical review.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u003c/strong\u003e No funding was received.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eClinical Trial Number\u003c/strong\u003e: Not applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eData is provided within the manuscript or supplementary information files.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Helsinki Declaration of 1964, its later updates, and comparable ethical principles, as well as institutional and national bodies\u0026rsquo; ethical standards, were all followed in the research involving human subjects. The Health Sciences Ethics Committee approved this study of Manisa Celal Bayar University Faculty of Medicine with the decision dated 01/07/2020 and No. 20.478.486/050\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed Consent statement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eInformed consent was obtained from all participants involved in the study and from parents/legal guardians of deceased participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eAll authors agreed to publish.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u003c/strong\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe authors declare no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eR. M. Ali et al., \u0026ldquo;Prognostic factors in renal cell carcinoma: A single‑center study,\u0026rdquo; Molecular and Clinical Oncology, vol. 19, no. 3, Jul. 2023, doi: 10.3892/mco.2023.2662.\u003c/li\u003e\n\u003cli\u003eK. Sunela et al., \u0026ldquo;Prognostic factors and long-term survival in renal cell cancer patients,\u0026rdquo; Scandinavian Journal of Urology and Nephrology, vol. 43, no. 6, p. 454, Dec. 2009, doi: 10.3109/00365590903286697.\u003c/li\u003e\n\u003cli\u003eA. Volpe and J. J. Patard, \u0026ldquo;Prognostic factors in renal cell carcinoma,\u0026rdquo; World Journal of Urology, vol. 28, no. 3. Springer Science+Business Media, p. 319, Apr. 02, 2010. doi: 10.1007/s00345-010-0540-8.\u003c/li\u003e\n\u003cli\u003eA. S. Belldegrun, \u0026ldquo;Renal Cell Carcinoma: Prognostic Factors and Patient Selection,\u0026rdquo; European Urology Supplements, vol. 6, no. 7, p. 477, Feb. 2007, doi: 10.1016/j.eursup.2007.01.016.\u003c/li\u003e\n\u003cli\u003eR. J. 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Yang et al., \u0026ldquo;The prognostic value of multiorgan metastases in patients with non-small cell lung cancer and its variants: a SEER-based study,\u0026rdquo; Journal of Cancer Research and Clinical Oncology, vol. 144, no. 9, p. 1835, Jul. 2018, doi: 10.1007/s00432-018-2702-9.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Renal cell carcinoma, Prognosis, Suvival","lastPublishedDoi":"10.21203/rs.3.rs-6991364/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6991364/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cem\u003eObjective.\u003c/em\u003e The aim of this study is to comprehensively analyze the prognostic significance of various clinical and pathological factors, including age, body mass index, Karnofsky performance score, International Metastatic Renal Cell Carcinoma Database Consortium (IMDC) risk score, accompanying chronic diseases and sites of metastasis, in determining the risk of mortality among patients with metastatic renal cell carcinoma.\u003c/p\u003e\u003cp\u003e\u003cem\u003eMaterial and Methods .\u003c/em\u003e 111 patients with RCC who presented to Manisa Celal Bayar University Research Hospital between 2000 and 2020 were included in the study. The collected data were analyzed retrospectively.\u003c/p\u003e\u003cp\u003e\u003cem\u003eResults.\u003c/em\u003e Univariate analysis showed a statistically significant reduction in the risk of death for patients with diabetes mellitus and chronic kidney disease. The multivariate analysis indicated a significantly increased risk of death for patients with non-clear cell RCC histology, liver metastasis, or metastases at other sites. Bone metastasis was associated with a decreased risk of death in both univariate and multivariate analyses. No significant association with mortality risk was observed for age, gender, Karnofsky performance score, stage at diagnosis, presence of lung, lymph node, and central nervous system metastases or IMDC risk score.\u003c/p\u003e\u003cp\u003e\u003cem\u003eConclusion.\u003c/em\u003e Liver metastasis and metastasis in areas other than lung, bone, CNS, or lymph nodes are associated with an increased risk of death in patients with metastatic renal cell carcinoma.\u003c/p\u003e","manuscriptTitle":"The Impact of Metastatic Site on Survival in Renal Cell Carcinoma","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-07-31 04:17:15","doi":"10.21203/rs.3.rs-6991364/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"c3dfa4b5-8335-4e0f-ba6e-17dbf814be01","owner":[],"postedDate":"July 31st, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-09-18T10:39:53+00:00","versionOfRecord":[],"versionCreatedAt":"2025-07-31 04:17:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6991364","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6991364","identity":"rs-6991364","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}