部分肾切除术与根治性肾切除术对较大肾细胞癌预后的对比研究

邵佳; 水冰; 李宁

doi:10.13201/j.issn.1001-1420.2019.08.012

部分肾切除术与根治性肾切除术对较大肾细胞癌预后的对比研究

- 1. 杭州市肿瘤医院泌尿外科(杭州, 310002);
- 2. 浙江大学医学院附属杭州市第一人民医院泌尿外科
基金项目:
杭州市科技发展计划项目（编号20150633B17）

详细信息

通讯作者: 邵佳,E-mail:1043866292@qq.com

中图分类号: R737.11

收稿日期: 2018-01-29

Influence of partial and radical nephrectomy on the prognosis of patients with large renal cell carcinoma

- 1. Department of Urology, Hangzhou Cancer Hospital, Hangzhou, 310002, China;
- 2. Department of Urology, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine

More Information

Corresponding author: SHAO Jia, E-mail: 1043866292@qq.com

Received Date: 29 January 2018

摘要

摘要: 目的：比较部分肾切除术与根治性肾切除术对较大肾细胞癌（>4cm）患者预后的影响。方法：选取2010年1月~2013年12月于我院就诊并行手术治疗的肾细胞癌患者为研究对象，肿瘤临床分期为T_1bN₀M₀或T₂N₀M₀期，按照手术方式分为部分肾切除术组与根治性肾切除术组，病例数1∶1，全部为开放性手术，比较患者术后截至2017年12月的总生存率（OS）、术后1个月内再入院率及术后1、3个月手术相关死亡率。结果：共计118例患者纳入研究，多变量分析显示部分肾切除术组患者中T_1b期与较好的总生存预后相关（HR=0.82，95% CI：0.72~0.88，P<0.001）；T₂期中部分肾切除术组对患者的生存有利，但差异无统计学意义（HR=0.84，95% CI：0.70~1.11，P=0.313）；部分肾切除术组患者术后1个月内因出血、尿漏等再入院率显著高于根治性肾切除术组（5.1% vs.3.4%，P<0.05），但两组术后1、3个月相关死亡率比较差异无统计学意义（P>0.05）。结论：对于较大的肾细胞癌，T_1b期患者行部分肾切除术较根治性肾切除术更有利于患者的生存预后，但T₂期患者2种手术方式对生存预后无显著性差异，≥T_1b期患者部分切除术后1个月内再入院率较根治性手术者显著升高。
- 肾细胞癌 /
- 部分肾切除术 /
- 根治性肾切除术 /
- 预后
Abstract: Objective: To investigate the effect of partial and radical nephrectomy on the prognosis of patients with large renal cell carcinoma (>4 cm).Method: The patients with renal cell carcinoma who were admitted to our hospital from January 2010 to December 2013 were selected as study subjects.The clinical stage of the tumor was T_1bN₀ M₀ or T₂ N₀ M₀.The patients were divided into two groups according to the operation methods.The rate of cases was 1:1 and all surgeries were traditional open surgeries.The total postoperative survival rate of patients (until December 2017), re-admission rate within 30 days, postoperative 1 month and 3 months related mortality between groups were compared.Result: A total of 118 patients were included.Multivariate analysis showed that those with T₁ bstage tumor who underwent partial nephrectomy were associated with better overall survival (HR=0.82, 95% CI:0.72-0.88, P<0.001);in the T₂ stage tumor partial resection was beneficial to patients' survival, but no significant difference (HR=0.84, 95% CI:0.70-1.11, P=0.313).The chance of rehospitalization within 30 days (mainly hemorrhage, urine leakage) after partial nephrectomy was significantly higher than that of radical resection group (5.1% vs.3.4%, P<0.05).However, there was no significant difference between the two groups in the incidence of related death events at 1 month and 3 months (P>0.05).Conclusion: In the case of large renal cell carcinoma, partial nephrectomy performed on T₁ bpatients is more beneficial to the prognosis than radical surgery.However, there is no significant difference of animation prognosis between the two groups in T₂ stage tumor.The probability of hospital readmission within 30 days of patients with renal cell carcinoma ≥ T₁ bafter radical surgery is lower compared with those after partial nephrectomy.
- renal cell carcinoma /
- partial nephrectomy /
- radical nephrectomy /
- prognosis

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