小肾细胞癌延迟手术与即刻手术的临床结局。
Clinical Outcome of Small Renal Cell Carcinoma after Delayed Surgery versus Immediate Surgery.
机构信息
1. Department of Urology, Kinki University Faculty of Medicine, Osaka-Sayama, Osaka, Japan; ; 2. Department of Urology, Sakai Hospital Kinki University Faculty of Medicine, Sakai, Osaka, Japan;
出版信息
J Cancer. 2013 Jul 19;4(6):514-8. doi: 10.7150/jca.6949. Print 2013.
BACKGROUND
This study was undertaken to investigate the growth rate and clinical outcome of patients with a small renal mass (SRM) after delayed surgery versus immediate surgery.
METHODS
We reviewed the clinical records of 328 patients with SRM ≦ 4cm at diagnosis, who underwent delayed or immediate surgical intervention from January 2000 to December 2011. Radiographic evaluation using CT scan and MRI were performed at least every 6 months and the tumor size was determined at least twice in the delayed surgery group.
RESULTS
A total of 292 RCC patients with pT1aN0M0 were identified; among them, 32 patients had been managed with delayed surgery intervention. No statistically significant difference was observed in overall survival rate (OSR) and cancer recurrence-free rate (CRFR). But cancer-specific survival rate (CSSR) was significantly lower in the delayed surgery group (p=0.0002).
CONCLUSIONS
The overall survival rate of delayed surgery was not inferior compared with that after immediate surgery. Delayed surgery intervention for SRMs is a treatment option in the current study.
背景
本研究旨在探讨小肾肿瘤（SRM）患者延迟手术与立即手术的生长速度和临床结果。
方法
我们回顾了 2000 年 1 月至 2011 年 12 月期间诊断为 ≦4cm 的 328 例 SRM 患者的临床记录，他们接受了延迟或立即手术干预。使用 CT 扫描和 MRI 进行影像学评估，至少每 6 个月进行一次，并在延迟手术组中至少进行两次肿瘤大小的测定。
结果
共确定了 292 例 pT1aN0M0 的 RCC 患者，其中 32 例接受了延迟手术干预。总体生存率（OSR）和癌症无复发生存率（CRFR）无统计学差异。但是，延迟手术组的癌症特异性生存率（CSSR）显著降低（p=0.0002）。
结论
延迟手术的总体生存率并不逊于立即手术。延迟手术干预 SRM 是目前研究中的一种治疗选择。
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