摘要
目的分析肾部分切除术(PN)和肾癌根治术(RN)对T1b期肾癌(RCC)预后的影响及相关因素,以期为提高RCC患者术后生存率提供依据。方法选取2010年2月至2014年3月在我院接受手术治疗的74例RCC患者为研究对象,按照手术方式的不同将其分为PN组(28例)与RN组(46例)。出院后开展36~60个月随访,比较两组患者术后3、5年的存活情况及肿瘤复发情况,并分析患者术后5年生存率的影响因素。结果PN组患者术后3、5年生存率均高于RN组,但差异无统计学意义(P>0.05);PN组复发转移率为25.00%,明显高于RN组的6.52%(P<0.05);转移或复发是影响T1b期RCC患者术后生存率的独立危险因素(P<0.05)。结论PN虽可提高T1b期RCC的5年生存率,但术后癌症的转移和复发相对较高;对于T1b期RCC选择PN还是RN应视结合患者肿瘤复发、转移的风险大小综合判定。
Objective To analyze the effect of partial nephrectomy (PN) and radical nephrectomy (RN) on the prognosis of stage T1b renal cell carcinoma (RCC) and the related factors, so as to provide basis for improving the survival rate of RCC after operation. Methods A total of 74 patients with RCC who underwent surgical treatment in our hospital from February 2010 to March 2014 were selected as the research objects. The patients were divided into PN group (28 cases) and RN group (46 cases) according to the different surgical methods. The patients were followed up for 36 to 60 months after discharge. The survival and recurrence of the tumors in the 3 and 5 years after operation were compared between the two groups, and the influencing factors of the 5-year survival rate in patients were analyzed. Results The 3 and 5 year survival rates in the PN group were higher than those in the RN group, but there were no significant differences (P>0.05). The recurrence and metastasis rate of the PN group was 25.00%, which was significantly higher than 6.52% of the RN group (P<0.05). Metastasis or recurrence was an independent risk factor for survival rate of patients with stage T1b RCC after operation (P<0.05). Conclusion Although PN can improve the 5 year survival rate of T1b RCC, the metastasis and recurrence of cancer after operation are relatively high. For T1b RCC, PN or RN should be judged comprehensively according to the risk of recurrence and metastasis.
作者
李永强
薛亚辉
郑伟
宫小勇
薛超辉
刘建舟
LI Yong-qiang;XUE Ya-hui;ZHENG Wei;GONG Xiao-yong;XUE Chao-hui;LIU Jian-zhou(the Second Affiliated Hospital of Shaanxi University of Chinese Medicine, Xianyang 712000;Baoji Central Hospital,Baoji 721008, China)
出处
《临床医学研究与实践》
2019年第25期24-25,28,共3页
Clinical Research and Practice
基金
陕西省宝鸡市卫计局科研课题(No.2014-07)
关键词
肾部分切除术
肾癌根治术
T1b期肾癌
生存率
partial nephrectomy
radical nephrectomy
T1b stage renal cell carcinoma
survival rate
