CAJ | 학술논문

目的探讨标准化肾肿瘤影像解剖特征与其手术方案的关系. 方法 202例T2期肾肿瘤患者,其中根治性切除术(RN)122例,部分肾切除术(PN)80例. 中位随访41.5个月. Kaplan-Meier分析比较整个队列和RENAL得分≥10和<10患者的总生存( OS) ,癌症特异性生存( CSS)和无进展生存期( PFS). 采用Cox比例风险分析PFS和OS的相关性. 结果 RN 患者和PN 患者的RENAL 评分无显著差异. RN 和 PN5 年PFS 分别为69.8%和79.9%( P =0.115),CSS分别是82.5%和86.7%(P=0.407),OS分别为80.0%和83.3%(P=0.291). Cox回归显示手术方式的不同与PFS无相关性. RENAL评分≥10分患者的PFS更短(风险比6.69,P=0.002). Kaplan-Meier分析RN患者和PN患者PFS无组间差异,RENAL得分≥10和<10患者的PFS无组间差异. 其次,OS在T2a和T2b肿瘤患者之间无差异;RENAL得分≥10的患者更容易死亡或死于其他病因(P<0.001). 结论 PN手术可能对T2期肾肿瘤患者有效.
목적 탐토표준화신종류영상해부특정여기수술방안적관계. 방법 202례T2기신종류환자,기중근치성절제술(RN)122례,부분신절제술(PN)80례. 중위수방41.5개월. Kaplan-Meier분석비교정개대렬화RENAL득분≥10화<10환자적총생존( OS) ,암증특이성생존( CSS)화무진전생존기( PFS). 채용Cox비례풍험분석PFS화OS적상관성. 결과 RN 환자화PN 환자적RENAL 평분무현저차이. RN 화 PN5 년PFS 분별위69.8%화79.9%( P =0.115),CSS분별시82.5%화86.7%(P=0.407),OS분별위80.0%화83.3%(P=0.291). Cox회귀현시수술방식적불동여PFS무상관성. RENAL평분≥10분환자적PFS경단(풍험비6.69,P=0.002). Kaplan-Meier분석RN환자화PN환자PFS무조간차이,RENAL득분≥10화<10환자적PFS무조간차이. 기차,OS재T2a화T2b종류환자지간무차이;RENAL득분≥10적환자경용역사망혹사우기타병인(P<0.001). 결론 PN수술가능대T2기신종류환자유효.
Objective To study the relationship between standardized imaging anatomical features of renal tumors and surgical options.Methods 202 patients with T2 renal tumors were divided into RN (122) group and PN (80) group,median fol-low-up was 41.5 months.Kaplan–Meier analysis compared overall survival ( OS) ,cancer-specific survival ( CSS) and progres-sion-free survival ( PFS) among the entire cohort and within categories of renal nephrometry score≥10 and<10.Association be-tween PFS and OS was analyzed using cox-proportional hazard.Results There were no significant differences between PN and RN in clinical T stage and renal nephrometry scores.For RN and PN,the 5-year PFS was 69.8%and 79.9%(P=0.115),CSS was 82.5%and 86.7%(P=0.407),and OS was 80.0%and 83.3%(P=0.291).Cox regression showed no association be-tween surgical options and PFS;a renal nephrometry score ≥ 10 was associated with a shorter PFS (hazard ratio 6.69,P=0.002) .Kaplan-Meier analysis surgical options showed no difference in PFS for entire cohort or within the renal nephrometry score categories≥10 and<10.The PFS was better for those with R.E.N.A.L nephrometry scores <10 vs≥10 ( P<0.001) and there had no significant difference in OS between T2a and T2b tumors (P=0.012).Patients with renal nephrometry scores≥10 were more likely to die from disease or other causes ( P<0.001) .Conclusion PN may be effective for T2 renal tumors.