中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2010年
3期
153-156
,共4页
宋希双%陈峰%吴东军%何中舟%李泉林%车翔宇%王建伯%殷积斌%李先承%张志伟
宋希雙%陳峰%吳東軍%何中舟%李泉林%車翔宇%王建伯%慇積斌%李先承%張誌偉
송희쌍%진봉%오동군%하중주%리천림%차상우%왕건백%은적빈%리선승%장지위
癌,肾细胞%保留肾单位手术%预后
癌,腎細胞%保留腎單位手術%預後
암,신세포%보류신단위수술%예후
Carcinoma,renal cell%Nephron sparing surgery%Prognosis
目的 探讨保留肾单位手术治疗肾细胞癌的长期疗效及安全性. 方法 回顾性分析243例保留肾单位手术的肾癌患者临床资料.男159例,女84例,平均年龄58(24～77)岁.肿瘤直径平均3.4(1.1～6.7)cm.孤立肾肾癌3例,双侧肾癌11例.TNM分期T_(1a) 237例,T_(1b) 6例;无区域淋巴结及远处转移,无肾静脉、腔静脉癌栓.术后随访行超声、CT、肾功能等检查.应用KaplanMeier方法行肿瘤特异性生存率估计并进行对数秩检验. 结果 243例中232例获随访,平均随访31(1～147)个月.术后应用干扰素继续治疗52例.死亡4例(因癌死亡1例,非癌死亡3例),总体生存率和肿瘤特异性生存率分别为98.3%和100.0%;肿瘤复发5例,远处转移1例.总并发症发生率为5.6%(13/232). 结论 保留肾单位手术治疗肾细胞癌局部复发率低,远期生存率高,并发症发生率低;可以最大限度地保留功能性肾单位,降低并发慢性肾衰竭的危险性,提高患者生活质量,增加患者满意度.
目的 探討保留腎單位手術治療腎細胞癌的長期療效及安全性. 方法 迴顧性分析243例保留腎單位手術的腎癌患者臨床資料.男159例,女84例,平均年齡58(24～77)歲.腫瘤直徑平均3.4(1.1～6.7)cm.孤立腎腎癌3例,雙側腎癌11例.TNM分期T_(1a) 237例,T_(1b) 6例;無區域淋巴結及遠處轉移,無腎靜脈、腔靜脈癌栓.術後隨訪行超聲、CT、腎功能等檢查.應用KaplanMeier方法行腫瘤特異性生存率估計併進行對數秩檢驗. 結果 243例中232例穫隨訪,平均隨訪31(1～147)箇月.術後應用榦擾素繼續治療52例.死亡4例(因癌死亡1例,非癌死亡3例),總體生存率和腫瘤特異性生存率分彆為98.3%和100.0%;腫瘤複髮5例,遠處轉移1例.總併髮癥髮生率為5.6%(13/232). 結論 保留腎單位手術治療腎細胞癌跼部複髮率低,遠期生存率高,併髮癥髮生率低;可以最大限度地保留功能性腎單位,降低併髮慢性腎衰竭的危險性,提高患者生活質量,增加患者滿意度.
목적 탐토보류신단위수술치료신세포암적장기료효급안전성. 방법 회고성분석243례보류신단위수술적신암환자림상자료.남159례,녀84례,평균년령58(24～77)세.종류직경평균3.4(1.1～6.7)cm.고립신신암3례,쌍측신암11례.TNM분기T_(1a) 237례,T_(1b) 6례;무구역림파결급원처전이,무신정맥、강정맥암전.술후수방행초성、CT、신공능등검사.응용KaplanMeier방법행종류특이성생존솔고계병진행대수질검험. 결과 243례중232례획수방,평균수방31(1～147)개월.술후응용간우소계속치료52례.사망4례(인암사망1례,비암사망3례),총체생존솔화종류특이성생존솔분별위98.3%화100.0%;종류복발5례,원처전이1례.총병발증발생솔위5.6%(13/232). 결론 보류신단위수술치료신세포암국부복발솔저,원기생존솔고,병발증발생솔저;가이최대한도지보류공능성신단위,강저병발만성신쇠갈적위험성,제고환자생활질량,증가환자만의도.
Objective To evaluate the long-term therapeutic results and the safety of nephronsparing surgery(NSS) for the treatment of renal cell carcinoma. Methods Clinical data of 243 NSSfor renal cell carcinoma were retrospectively analysed. Of them, 159 were males and 84 were femaleswith average age of 58 years (range from 24 ?77 years). The average tumor size was 3. 4 cm (rangefrom 1.1 to 6. 7 cm). Three cases were solitary renal cell carcinoma, 11 were bilateral renal cell carcinoma; 237 cases were in stage T_(1a). and 6 cases were in stage T_(1b). No lymph node and distant metastasis, no renal vein cancer tumor embolus and inferior vena cava tumor embolus was found. Postoperative follow-up was carried out by ultrasound, CT and renal function. Cancer specific survival was estimated using Kaplan-Meier method and log-rank test. Results After a mean 31 months (1-147months) follow-up, long-term follow-up data were obtained in 232 cases because the other 11 did notlive in Dalian, 52 were treated with interferon. Four of the 232 patients treated with NSS had died:1died from lung cancer 16 months after lung cancer treatment, the other 3 died from cardiovascular diseases. The total survival rate and cancer specific survival rate were 98. 3% and 100. 0%, respectively.Local tumor recurrences were detected in 5 patients and tumor metastasis was detected in 1 patient.The recurrence rate was 2. 2%, and the metastasis rate was 0. 4%. The complications included temporary renal failure and urine leakage. The complication rate was 5. 6%. Conclusions NSS for renalcell carcinoma is a safe and feasible treatment option. It has the advantages of low local recurrence,good long-term survival rate and low complication rate. NSS can maximally reserve functional nephron, reduce the risk of chronic renal failure, preserve patient's quality of life and increase patient'ssatisfaction.
