CAJ | 학술논문

目的探讨散发性双肾多发性肾细胞癌的治疗原则,以提高治疗水平. 方法回顾性分析2000年1月至2011年7月收治的7例散发性双肾多发性肾细胞癌患者的资料.男4例,女3例.年龄40 ～ 73岁,平均57岁.无家族病史.7例均为查体或其他疾病就诊时发现.同时发现双肾癌4例,一侧肾癌术后随访发现对侧肾癌3例,未发现其他脏器及淋巴结转移.肿瘤分布于肾中央及外周,最多者一侧16枚.肿瘤直径0.8～6.0 cm,平均4.1 cm.肿瘤临床分期T1a3例,T1b 3例.结果 1例行单侧肾动脉栓塞者7个月后失访；1例靶向治疗2个疗程后双肾分期行保留肾单位(NSS)手术；3例一侧行根治术,对侧择期行NSS手术；2例双肾择期行NSS手术.7例患者病理报告均为肾透明细胞癌.6例术后随访6 ～ 96个月,平均40个月,肿瘤无复发. 结论双肾多发肾细胞癌患者应积极实行手术治疗,以切除肿瘤、最大限度地保留肾单位为原则.患者预后不因双肾受累及肿瘤多发而受到明显影响.
목적 탐토산발성쌍신다발성신세포암적치료원칙,이제고치료수평. 방법 회고성분석2000년1월지2011년7월수치적7례산발성쌍신다발성신세포암환자적자료.남4례,녀3례.년령40 ～ 73세,평균57세.무가족병사.7례균위사체혹기타질병취진시발현.동시발현쌍신암4례,일측신암술후수방발현대측신암3례,미발현기타장기급림파결전이.종류분포우신중앙급외주,최다자일측16매.종류직경0.8～6.0 cm,평균4.1 cm.종류림상분기T1a3례,T1b 3례.결과 1례행단측신동맥전새자7개월후실방；1례파향치료2개료정후쌍신분기행보류신단위(NSS)수술；3례일측행근치술,대측택기행NSS수술；2례쌍신택기행NSS수술.7례환자병리보고균위신투명세포암.6례술후수방6 ～ 96개월,평균40개월,종류무복발. 결론 쌍신다발신세포암환자응적겁실행수술치료,이절제종류、최대한도지보류신단위위원칙.환자예후불인쌍신수루급종류다발이수도명현영향.
Objective To discuss the surgical strategies for bilateral multifocal renal cell carcinoma (BMRCC).Metbods Seven patients of BMRCC were reviewed.The clinical characteristics,surgical procedure,tumor pathology and follow-up results were collected.Of the 7 patients,4 were males; the mean age was 57.Four diagnosed synchronous BMRCC,the other 3 were found contralateral renal carcinoma during follow-up after RCC surgical treatment.One patient was treated with unilateral renal artery embolization.Three cases were had a radical nephrectomy and another side got staged NSS.And the other 3 patients applied staged NSS.Results All the 7 patients were diagnosed as renal cell carcinoma pathologically.The follow-up duration was 6 to 96 months after last operation,and all showed no tumor recurrence.Conclusions For patients with BMRCC,surgical strategies should be performed positively.The prognosis of these patients cannot be obviously affected by bilaterality and multifocality of the lesions.