Green D M, Breslow N E, Ii Y, Grundy P E, Shochat S J, Takashima J, D'Angio G J
Department of Pediatrics, Roswell Park Memorial Institute, Buffalo, NY.
J Pediatr Surg. 1991 Jun;26(6):728-33. doi: 10.1016/0022-3468(91)90021-k.
To determine the effect of surgical excision of pulmonary metastases from Wilms' tumor on postrelapse survival, we retrospectively analyzed the clinical courses of 211 patients with stages I to III, favorable or unfavorable histology Wilms' tumor entered on National Wilms' Tumor Study-1, -2, or -3 whose first recurrence was limited to the lungs. There was no difference in the 4-year postrelapse survival percentage of favorable-histology patients with a solitary pulmonary metastasis who did or did not undergo surgical removal of the metastasis in addition to pulmonary irradiation and chemotherapy. Although histological confirmation of pulmonary relapse is frequently indicated, the present data suggest that therapeutic removal of pulmonary metastases from patients with relapsed Wilms' tumor does not increase the percentage of patients who survive for 4 years postrelapse, compared with treatment with whole-lung irradiation and chemotherapy.
为确定手术切除肾母细胞瘤肺转移灶对复发后生存的影响，我们回顾性分析了211例I至III期、组织学类型为预后良好或不良的肾母细胞瘤患者的临床病程，这些患者参加了国家肾母细胞瘤研究-1、-2或-3，其首次复发局限于肺部。对于组织学类型预后良好且有孤立性肺转移的患者，除了肺部放疗和化疗外，接受或未接受转移灶手术切除的患者，其复发后4年生存率无差异。尽管经常需要对肺复发进行组织学确认，但目前的数据表明，与全肺放疗和化疗相比，对复发的肾母细胞瘤患者进行肺转移灶的治疗性切除并不能提高复发后4年生存患者的比例。
