Dall'Oglio Marcos Francisco, Srougi Miguel, Gonçalves Pierre Damião, Leite Kátia, Nesrallah Luciano, Hering Flávio
Hospital Sírio Libanês and Hospital Beneficência Portuguesa de São Paulo, São Paulo, Brazil.
Sao Paulo Med J. 2002 Nov 1;120(6):165-9. doi: 10.1590/s1516-31802002000600002. Epub 2003 Jan 22.
Renal cell carcinoma is the third most frequent genitourinary neoplasia, and there is currently an increase in the incidental diagnosis of tumors confined to the kidneys.
To study the survival of patients with incidental and symptomatic renal tumors who have undergone nephrectomy.
Retrospective.
Hospital Sírio Libanês and Hospital Beneficência Portuguesa de São Paulo.
115 patients with diagnosis of renal cell carcinoma, operated on by the same group of surgeons and evaluated by a single pathologist.
Sex, age and diagnosis method, analyzed in two groups, according to the tumor diagnosis: Group 1 with incidental diagnosis and Group 2 with symptomatic tumors. The anatomopathological characteristics and patient survival in both groups were evaluated. A statistical analysis was performed using the Student t, chi-squared, log rank and Kaplan-Meyer tests.
Among the studied patients, 59(51%) had an incidental diagnosis, with 78% diagnosed by ultrasonography, 20% by computerized tomography scan and 2% during surgeries; 56 patients (49%) were symptomatic. Tumor locations were equally distributed between the two kidneys, and the surgery was conservative for 24% of the incidental and 9% of the symptomatic group. In the incidental group only one patient had tumor progression and there was no death, while in the symptomatic group there were 5 progressions and 10 deaths. The 5-year specific cancer-free survival was 100% in the incidental and 80% in the symptomatic group (p = 0.001) while the disease-free rate was 98% in the incidental and 62% in the symptomatic group (p < 0001).
Incidental renal tumor diagnosis offers better prognosis, providing longer disease-free survival.
肾细胞癌是第三常见的泌尿生殖系统肿瘤，目前局限于肾脏的肿瘤偶然诊断率有所增加。
研究接受肾切除术的偶然发现和有症状的肾肿瘤患者的生存率。
回顾性研究。
黎巴嫩叙利亚医院和圣保罗葡萄牙慈善医院。
115例诊断为肾细胞癌的患者，由同一组外科医生进行手术，并由一名病理学家进行评估。
根据肿瘤诊断分为两组，分析性别、年龄和诊断方法：第1组为偶然诊断，第2组为有症状的肿瘤。评估两组的解剖病理学特征和患者生存率。使用学生t检验、卡方检验、对数秩检验和Kaplan - Meyer检验进行统计分析。
在研究的患者中，59例（51%）为偶然诊断，其中78%通过超声诊断，20%通过计算机断层扫描诊断，2%在手术中诊断；56例患者（49%）有症状。肿瘤在双侧肾脏的分布相同，偶然诊断组24%和有症状组9%的患者接受了保守手术。偶然诊断组仅1例患者出现肿瘤进展且无死亡，而有症状组有5例进展和10例死亡。偶然诊断组5年特定无癌生存率为100%，有症状组为80%（p = 0.001），而偶然诊断组无病率为98%，有症状组为62%（p < 0.001）。
偶然诊断的肾肿瘤预后较好，无病生存期更长。
