Stephens R, Graham S D
Department of Surgery, Emory University School of Medicine, Atlanta, Georgia.
Cancer. 1990 Jun 15;65(12):2663-7. doi: 10.1002/1097-0142(19900615)65:12<2663::aid-cncr2820651211>3.0.co;2-#.
In patients with renal insufficiency, solitary kidney, or bilateral renal malignancies, conservative surgery for renal cell carcinoma has been suggested. The authors treated 17 such patients with either enucleation of tumor or partial nephrectomy. Overall survival from disease in this series was 58.8%. Seventy percent of patients undergoing enucleation and 42.9% undergoing partial nephrectomy survived with a mean follow-up period of 5 years. Survival or local recurrence rate after enucleative surgery is an effective treatment of renal carcinoma in selected patients, and despite concerns about tumor invasion of the pseudocapsule, the clinical data do not indicate any difference in survival. There was no significant difference between enucleation of tumor and partial nephrectomy regarding morbidity, mortality, or recurrence rate.
对于肾功能不全、孤立肾或双侧肾恶性肿瘤患者，有人建议对肾细胞癌采取保守性手术。作者对17例此类患者进行了肿瘤剜除术或部分肾切除术治疗。该系列患者的疾病总生存率为58.8%。接受剜除术的患者中有70%存活，接受部分肾切除术的患者中有42.9%存活，平均随访期为5年。剜除性手术后的生存率或局部复发率表明，在特定患者中，该手术是治疗肾癌的有效方法，尽管有人担心肿瘤侵犯假包膜，但临床数据并未显示生存率有任何差异。在发病率、死亡率或复发率方面，肿瘤剜除术与部分肾切除术之间没有显著差异。
