Uygur M C, Usubütün A, Ozen H, Ayhan A, Kendi S
Dept. of Urology, Hacettepe University, Faculty of Medicine, Turkey.
J Exp Clin Cancer Res. 1999 Sep;18(3):397-401.
The objective of this study is to evaluate the prognostic factors and the role of nephrectomy in metastatic renal cell carcinoma. We reviewed 62 cases of metastatic renal cell carcinoma to document the factors influencing survival and to evaluate the role of nephrectomy. Sex and age of patients, size of primary tumor, site and number of metastases, nephrectomy, cell type and grade of tumor and medical treatment were analyzed as prognostic factors. Age and sex, cell type and type of medical treatment cannot be considered reliable predicting factors. However, improved survival was correlated with tumor size < or = 7 cm in diameter, low grade histology, metastasis limited to single organ and removal of the primary tumor. When these parameters were analyzed in a multivariate model, the presence of nephrectomy was the sole significant parameter. We therefore suggest that nephrectomy should be considered in all patients with metastatic renal cell carcinoma, as long as the morbidity of the operation is acceptable.
本研究的目的是评估转移性肾细胞癌的预后因素以及肾切除术的作用。我们回顾了62例转移性肾细胞癌病例，以记录影响生存的因素并评估肾切除术的作用。分析了患者的性别和年龄、原发肿瘤大小、转移部位和数量、肾切除术、肿瘤细胞类型和分级以及药物治疗等预后因素。年龄和性别、细胞类型以及药物治疗类型不能被视为可靠的预测因素。然而，生存期的延长与直径≤7 cm的肿瘤大小、低级别组织学、局限于单个器官的转移以及原发肿瘤的切除相关。当在多变量模型中分析这些参数时，肾切除术的实施是唯一显著的参数。因此，我们建议，只要手术的发病率可以接受，所有转移性肾细胞癌患者均应考虑行肾切除术。
