Fujioka T, Hasegawa M, Satoh F, Ishikura I, Matsuzaka J, Yoh T, Kumasaka K, Ugiie T, Nomura K, Okamoto T
Department of Urology, Iwata Medical University School of Medicine.
Nihon Hinyokika Gakkai Zasshi. 1990 Dec;81(12):1869-76. doi: 10.5980/jpnjurol1989.81.1869.
Six patients with synchronous bilateral renal cell carcinoma were treated surgically over a 7-year period in our department. They were all males and the mean age was 60.3 years. They comprised 7.1% of all patients with renal cell carcinoma encountered during the same period. In four out of the six cases, radical nephrectomy for the larger tumor plus partial nephrectomy for contralateral kidney was performed simultaneously. In the remaining two cases, bilateral partial nephrectomy was performed simultaneously or as separate procedures. Two patients required chronic hemodialysis and died of cardio-pulmonary insufficiency on the 70th and 75th day. One patient, who underwent bilateral partial nephrectomy with incomplete tumor removal, subsequently died of metastatic disease at 27 months. Although one of them required transient hemodialysis, the remaining three patients were alive and disease-free 84, 42, and 17 months after operation, without evidence of tumor. This series suggests that partial nephrectomy is an appropriate option in the management of selected cases of bilateral renal cell carcinoma.
在我们科室的7年时间里,对6例同步双侧肾细胞癌患者进行了手术治疗。他们均为男性,平均年龄为60.3岁。他们占同期所有肾细胞癌患者的7.1%。6例中的4例,对较大肿瘤进行根治性肾切除术,同时对侧肾脏进行部分肾切除术。其余2例,同时或分别进行双侧部分肾切除术。2例患者需要长期血液透析,并在第70天和第75天死于心肺功能不全。1例接受双侧部分肾切除术但肿瘤切除不完全的患者,随后在27个月时死于转移性疾病。虽然其中1例需要短期血液透析,但其余3例患者在术后84、42和17个月时存活且无疾病,无肿瘤迹象。该系列研究表明,部分肾切除术是双侧肾细胞癌特定病例管理中的一种合适选择。