CAJ | 학술논문

目的比较低级别上尿路上皮癌保肾手术与肾输尿管根治术治疗的临床效果.方法检索Pubmed、Springer、ScieneeDirect、万方数据库、中国期刊全文数据库、中国生物医学文献数据库及配合手工检索全面收集关于保肾手术与肾输尿管根治术治疗低级别上尿路上皮癌的临床对照研究文献,并按有关Cochrane协作网推荐的方法对术后5年生存率及5年肿瘤特异性生存率进行Meta分析.结果按照纳入标准共纳入6篇文献,436例患者,其中保肾手术组共计177例,肾输尿管根治术组共计259例,分析显示,两组术后5年生存率差异无统计学意义,合并RR值为0.95(95％CI=0.61～1.48,P＞0.05);术后5年肿瘤特异性生存率差异无统计学意义,合并RR值为0.83(95％ CI=0.42～1.64,P＞0.05).结论采用保肾手术方式与肾输尿管根治术治疗低级别上尿路上皮癌,5年后总生存率及肿瘤特异性生存率均无明显差别,两者疗效相当;但由于保肾手术损伤较小,因此临床医师可根据患者的个体差异选择性行保肾手术.
목적 비교저급별상뇨로상피암보신수술여신수뇨관근치술치료적림상효과.방법 검색Pubmed、Springer、ScieneeDirect、만방수거고、중국기간전문수거고、중국생물의학문헌수거고급배합수공검색전면수집관우보신수술여신수뇨관근치술치료저급별상뇨로상피암적림상대조연구문헌,병안유관Cochrane협작망추천적방법대술후5년생존솔급5년종류특이성생존솔진행Meta분석.결과 안조납입표준공납입6편문헌,436례환자,기중보신수술조공계177례,신수뇨관근치술조공계259례,분석현시,량조술후5년생존솔차이무통계학의의,합병RR치위0.95(95％CI=0.61～1.48,P＞0.05);술후5년종류특이성생존솔차이무통계학의의,합병RR치위0.83(95％ CI=0.42～1.64,P＞0.05).결론 채용보신수술방식여신수뇨관근치술치료저급별상뇨로상피암,5년후총생존솔급종류특이성생존솔균무명현차별,량자료효상당;단유우보신수술손상교소,인차림상의사가근거환자적개체차이선택성행보신수술.
Objectives To compare the therapeutic effects of nephron-sparing management versus radical nephroureterectomy management for low-grade upper tract urothelial carcinomas.Methods Literatures on the therapy of low-grade upper tract urothelial carcinoma by nephron-sparing management or radical nephroureterectomy management were collected from Pubmed,Springer,ScienceDirect,WANFANG,CNKI and CBM.Meta analysis was conducted for the date about the 5-year survival rate and disease-specific survival rate,according to Cochrane Collaboration.Results A total of 6 studies including 436 patients were identified and analyzed.The results showed no significant differences in the 5-year survival rate(RR =0.95,95 ％ CI =0.61 ～ 1.48,P ＞ 0.05) and 5 -year disease-specific survival rate(RR =0.83,95％CI =0.42 ～ 1.64,P ＞0.05).Conclusions A comparison between nephron-sparing management and radical nephroureterectomy management for low-grade upper tract urothelial carcinomas shows no significant differences in terms of 5-year survival rate and 5-year disease-specific survival rate,and has the same therapeutic effect; But the injury of the former is lower,so the clinicians could selectively use nephron-sparing management according to the individual differences of patients.