Gutiérrez Baños J L, Martín García B, Hernández Rodríguez R, Portillo Martín J A, Correas Gómez M A, Concepción Masip T, Fernández Gómez J M
Servicio de Urología, Hospital Universitario Valdecilla, Santander.
Actas Urol Esp. 1991 Sep-Oct;15(5):455-8.
A total of 38 renal adenocarcinomas with isolated invasion of the renal vein and maximum local extension to perirenal fat, operated over a 20-year period and with long-term follow-up were reviewed. They were divided in two subgroups, 12 T1-2,N0,M0,V1 cases were compared to 54 T1-2,N0,M0,V0 cases treated in the same period of time, but no significant differences were found in survival (83% and 68% at 5 and 10 years for V1 versus 80% and 64% for V0); and 26 T3,N0,M0,V1 cases compared to 49 T3,N0,M0,V0, again with no significant difference found in survival (40% at 5 years and 26.5% at 7 years for V1, versus 38.5% and 34% for T3V0). When comparing the survival rate of T1-2,N0,M0,V0-1 with that of T3,N0,M0,V0-1, the difference was significant (p). It is concluded that the isolated invasion of the renal vein and an equal locoregional extension of the tumour do not modify the prognosis for renal carcinoma, and that this parameter should be included in the new TNM classification of the isolated UICC, since when included within the T3b category it places cases with good prognosis (T1-2 V1) above cases with poor prognosis due to the existence of invasion of the perirenal fat (T3a).
回顾了20年间接受手术并进行长期随访的38例孤立性肾静脉侵犯且肿瘤最大局部扩展至肾周脂肪的肾腺癌。将其分为两个亚组，12例T1-2、N0、M0、V1病例与同期治疗的54例T1-2、N0、M0、V0病例进行比较，但生存情况无显著差异（V1组5年和10年生存率分别为83%和68%，V0组为80%和64%）；26例T3、N0、M0、V1病例与49例T3、N0、M0、V0病例比较，生存情况同样无显著差异（V1组5年生存率为40%，7年为26.5%，T3V0组为38.5%和34%）。比较T1-2、N0、M0、V0-1与T3、N0、M0、V0-1的生存率时，差异有统计学意义（p）。结论是，肾静脉的孤立性侵犯以及肿瘤同等的局部区域扩展并不改变肾癌的预后，并且该参数应纳入国际抗癌联盟（UICC）孤立性肾癌的新TNM分类中，因为当纳入T3b类别时，它将预后良好的病例（T1-2 V1）置于因存在肾周脂肪侵犯而预后较差的病例（T3a）之上。
