Iimura Yasumasa, Kihara Kazunori, Saito Kazutaka, Masuda Hitoshi, Kobayashi Tsuyoshi, Kawakami Satoru
Department of Urology, Graduate School, Tokyo Medical and Dental University, Tokyo, Japan.
Int J Urol. 2008 Jan;15(1):44-7. doi: 10.1111/j.1442-2042.2007.01922.x.
To date, follow-up after minimum incision endoscopic radical nephrectomy (MIES radical nephrectomy) for renal cell carcinoma (RCC) has not been reported. Minimum incision indicates an incision that narrowly permits the extraction of the specimen. To evaluate the oncological outcome of the patients with pathologically organ confined (pT1-2N0M0) RCC treated with this operation, the results in those patients were analyzed.
From 1998 to 2006, 154 consecutive patients underwent MIES radical nephrectomy under diagnosis of clinical T1-2N0M0 RCC in our hospital. Of the patients, 127 patients with pathologically confirmed organ confined (pT1-2N0M0) RCC constituted the current study population. Overall, the recurrence-free and cancer-specific survival rates of the patients treated with MIES radical nephrectomy were calculated using the Kaplan-Meier method and compared with those of the patients treated with open radical nephrectomy using the log rank test.
The median follow-up period was 34 months (range: 3-98 months). Of the 127 pT1-2N0M0 patients treated with MIES radical nephrectomy, the disease recurred in nine patients and four patients died of the cancer during follow-up. The five-year overall, recurrence-free and cancer-specific survival rates were 95.0%, 90.8% and 95.8%, respectively. Overall, the recurrence-free and cancer-specific survival rates were not different from those of patients treated with open radical nephrectomy.
MIES radical nephrectomy has the validity in adequate cancer control and is one of the recommendable options as a minimally invasive surgery for patients with organ confined RCC.
迄今为止,尚未有关于肾细胞癌(RCC)行最小切口内镜根治性肾切除术(MIES根治性肾切除术)后随访情况的报道。最小切口是指仅能勉强取出标本的切口。为评估接受该手术治疗的病理分期为器官局限性(pT1-2N0M0)的RCC患者的肿瘤学结局,对这些患者的结果进行了分析。
1998年至2006年,我院154例临床诊断为T1-2N0M0期RCC的患者连续接受了MIES根治性肾切除术。其中,127例病理确诊为器官局限性(pT1-2N0M0)RCC的患者构成了当前的研究人群。总体而言,采用Kaplan-Meier法计算接受MIES根治性肾切除术患者的无复发生存率和癌症特异性生存率,并使用对数秩检验与接受开放性根治性肾切除术患者的生存率进行比较。
中位随访期为34个月(范围:3-98个月)。在127例接受MIES根治性肾切除术的pT1-2N0M0患者中,9例患者疾病复发,4例患者在随访期间死于癌症。5年总生存率、无复发生存率和癌症特异性生存率分别为95.0%、90.8%和95.8%。总体而言,无复发生存率和癌症特异性生存率与接受开放性根治性肾切除术的患者无差异。
MIES根治性肾切除术在充分控制癌症方面具有有效性,是器官局限性RCC患者微创手术的推荐选择之一。