Chow Ji-Jian, Ahmed Kamran, Fazili Zahoor, Sheikh Mohammed, Sheriff Matin
Department of General Surgery, Queen Elizabeth's Hospital Woolwich, London, UK.
MRC Centre for Transplantation, King's College London, King's Health Partners, Department of Urology, Guy's Hospital, London, UK.
Rev Urol. 2014;16(2):76-82.
Renal cell carcinoma without metastasis responds well to surgical excision but is known to recur postnephrectomy. In a small but significant number of patients this recurrence is not accompanied by metastasis, which is important as these people benefit from further surgery. We examined 20 articles from the current literature to ascertain how best to treat this condition. Surgical management renders better results than conservative or medical therapies. Readily available investigations such as blood tests and computed tomography can help determine the right patients for surgery in an evidence-based fashion. Current findings have allowed us to suggest a protocol for the treatment of solitary renal fossa recurrence of postnephrectomy renal cell carcinoma. There are further opportunities for study in validating our protocol, and in novel renal cell carcinoma treatment strategies that have not been tested on solitary renal fossa recurrences.
无转移的肾细胞癌对手术切除反应良好，但已知在肾切除术后会复发。在一小部分但数量可观的患者中，这种复发并不伴有转移，这一点很重要，因为这些患者能从进一步手术中获益。我们查阅了当前文献中的20篇文章，以确定如何最好地治疗这种疾病。手术治疗比保守治疗或药物治疗效果更好。诸如血液检查和计算机断层扫描等易于获得的检查有助于以循证方式确定适合手术的患者。目前的研究结果使我们能够提出一个治疗肾切除术后肾细胞癌孤立性肾窝复发的方案。在验证我们的方案以及在尚未针对孤立性肾窝复发进行测试的新型肾细胞癌治疗策略方面，还有进一步的研究机会。
