Hashimoto Kohei, Hisasue Shin-ichi, Yanase Masahiro, Takahashi Atsushi, Hisataki Toshihiro, Kitamura Hiroshi, Masumori Naoya, Itoh Naoki, Tsukamoto Taiji
The Department of Urology, Sapporo Medical University.
Hinyokika Kiyo. 2005 Sep;51(9):621-5.
We evaluated the relationship between regional lymph node metastasis and tumor size in patients with M0 renal cell carcinoma who received regional lymph node dissection. The study involved 234 of the 247 patients with localized renal cell carcinoma who underwent radical nephrectomy with lymph node dissection at our institute between 1985 and 1999. Patients were arbitrarily classified into 3 groups by the greatest diameter of the tumor on preoperative computed tomography (CT): 4.0 cm or less (group A), 4.1 to 7.0 cm (group B), and 7.1 cm or more (group C). The incidence of lymph node metastasis was assessed in each group. The current study showed that 11 (4.7%) of the 234 patients with lymph node dissection together with radical nephrectomy were lymph node positive. The incidences of lymph node metastasis were 4.0% in group A, 2.3% in group B, and 8.4% in group C (p = 0.79). Of these 11 patients with lymph node metastasis, 2 (18.2%) have so far survived for over 5 years following surgery. Although the role of regional lymph node dissection with radical nephrectomy might be limited and controversial in renal cell carcinoma, urological surgeons should always be aware of possible metastasis for any tumor size.
我们评估了接受区域淋巴结清扫术的M0期肾细胞癌患者区域淋巴结转移与肿瘤大小之间的关系。该研究纳入了1985年至1999年间在我院接受根治性肾切除术及淋巴结清扫术的247例局限性肾细胞癌患者中的234例。根据术前计算机断层扫描（CT）上肿瘤的最大直径，将患者任意分为3组：4.0 cm及以下（A组）、4.1至7.0 cm（B组）和7.1 cm及以上（C组）。评估每组患者的淋巴结转移发生率。当前研究表明，234例接受淋巴结清扫术及根治性肾切除术的患者中有11例（4.7%）淋巴结阳性。A组淋巴结转移发生率为4.0%，B组为2.3%，C组为8.4%（p = 0.79）。在这11例有淋巴结转移的患者中，有2例（18.2%）术后存活至今超过5年。尽管在肾细胞癌中，根治性肾切除术联合区域淋巴结清扫术的作用可能有限且存在争议，但泌尿外科医生应始终意识到任何肿瘤大小都可能发生转移。
