Fergany A F, Hafez K S, Novick A C
Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
J Urol. 2000 Feb;163(2):442-5.
Partial nephrectomy is effective for renal cell carcinoma when preservation of renal function is a concern. We present the 10-year followup of patients treated with nephron sparing surgery at our institution.
Partial nephrectomy was performed in 107 patients with localized sporadic renal cell carcinoma before December 1988. Tumors were symptomatic in 73 patients (68%) and indications for surgery were imperative in 96 (90%). Of the patients 42 (39%) had renal insufficiency preoperatively. All patients were followed a minimum of 10 years or until death.
At the end of the followup interval 32 patients (30%) had no evidence of recurrence, 28 (26%) died of metastatic renal cell carcinoma and 46 (42%) died of unrelated causes. Cancer specific survival was 88.2% at 5 and 73% at 10 years, and was significantly affected by tumor stage, symptoms, tumor laterality and tumor size. Long-term renal function was stable in 52 patients (49%).
Partial nephrectomy is effective for localized renal cell carcinoma, providing long-term tumor control with preservation of renal function.
当需要关注肾功能保留时,部分肾切除术对肾细胞癌有效。我们展示了在我们机构接受保留肾单位手术治疗的患者的10年随访结果。
1988年12月前,对107例局限性散发性肾细胞癌患者实施了部分肾切除术。73例患者(68%)的肿瘤有症状,96例(90%)的手术指征为迫切需要。42例患者(39%)术前存在肾功能不全。所有患者至少随访10年或直至死亡。
在随访期结束时,32例患者(30%)无复发迹象,28例(26%)死于转移性肾细胞癌,46例(42%)死于无关原因。5年时癌症特异性生存率为88.2%,10年时为73%,且受肿瘤分期、症状、肿瘤位置和肿瘤大小的显著影响。52例患者(49%)的长期肾功能稳定。
部分肾切除术对局限性肾细胞癌有效,可在保留肾功能的情况下实现长期肿瘤控制。