肾细胞癌行部分肾切除与根治性肾切除术后肾功能的比较。
Comparison of renal function after partial nephrectomy and radical nephrectomy for renal cell carcinoma.
作者信息
Miyamoto Katsutoshi, Inoue Shogo, Kajiwara Mitsuru, Teishima Jun, Matsubara Akio
机构信息
Department of Urology, Hiroshima University Graduate School of Biomedical Sciences, Hiroshima, Japan. sppw2d99 @ hyper.ocn.ne.jp
出版信息
Urol Int. 2012;89(2):227-32. doi: 10.1159/000339969. Epub 2012 Jul 27.
OBJECTIVE
To investigate the time-dependent changes of estimated glomerular filtration rate (eGFR) after radical nephrectomy (RN) and partial nephrectomy (PN) for renal cell carcinoma (RCC) and to determine the risk factors for the new onset of a postoperative eGFR <60 ml/min/1.73 m(2).
PATIENTS AND METHODS
We assessed the renal function of 253 RCC patients by using the eGFR, and investigated the time-dependent changes of the eGFR after the operation. Regression models were used to determine risk factors for the new onset of an eGFR of <60 ml/min/1.73 m(2) in 211 patients who had at least one month of postoperative follow-up.
RESULTS
From the first postoperative day to the 60th postoperative month the eGFR in the RN group was significantly lower than that in the PN group. For patients who had at least 1 month of postoperative follow-up, multivariable analysis revealed that RN (p < 0.001), age (p = 0.028), and maleness (p = 0.013) were risk factors for the postoperative onset of an eGFR <60 ml/min/1.73 m(2).
CONCLUSIONS
Renal function after PN was better than that after RN, and RN was a greater risk factor for the postoperative onset of an eGFR <60 ml/min/ 1.73 m(2).
目的
探讨根治性肾切除术（RN）和肾部分切除术（PN）治疗肾细胞癌（RCC）后估计肾小球滤过率（eGFR）随时间的变化，并确定术后新发eGFR<60 ml/min/1.73 m²的危险因素。
患者与方法
我们使用eGFR评估了253例RCC患者的肾功能，并研究了术后eGFR随时间的变化。采用回归模型确定211例术后至少随访1个月的患者中eGFR<60 ml/min/1.73 m²新发的危险因素。
结果
从术后第1天到术后第60个月，RN组的eGFR显著低于PN组。对于术后至少随访1个月的患者进行多变量分析显示，RN（p<0.001）、年龄（p=0.028）和男性（p=0.013）是术后eGFR<60 ml/min/1.73 m²新发的危险因素。
结论
PN后的肾功能优于RN，且RN是术后新发eGFR<60 ml/min/1.73 m²的更大危险因素。
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