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术前影像学和术后病理结果对因肾细胞癌行根治性肾切除术后患者生存的影响。

Impact of preoperative radiological and postoperative pathological findings on survival of patients after radical nephrectomy performed with the indication of renal cell carcinoma.

作者信息

Şimşek Abdulmuttalip, Küçüktopcu Onur, Akbulut Fatih, Özgör Faruk, Küçüktopcu Elif, Savun Metin, Berberoğlu Yalçın, Gürbüz Gökhan

机构信息

Department of Urology, Haseki Training and Research Hospital, İstanbul, Turkey.

Fatih Social Health Center, İstanbul, Turkey.

出版信息

Turk J Urol. 2015 Mar;41(1):1-6. doi: 10.5152/tud.2015.78800.

Abstract

OBJECTIVE

To evaluate the impact of preoperative radiological and postoperative pathological findings on survival of patients after radical nephrectomy because of renal cell carcinoma (RCC).

MATERIAL AND METHODS

We performed 159 consecutive radical nephrectomy between December 2007 and January 2014. We evaluated age, gender, complaints, operation time, comorbidity, computed tomography (CT) and magnetic resonance graphy (MRG) results. Size of the mass, lymph node involvement, renal vein invasion, and presence of metastases were investigated. During histopathological examination, especially, pathological diagnosis, subtypes of RCC, lymph node involvement, lymphovascular, perineural invasion, and capsular, renal pelvis invasion, and renal vein involvement were sought. Follow-up periods of the patients were determined based on dates of death of the patients, and the study period.

RESULTS

RCC was seen in 124 (78%) of patients. Mean estimated suvival of RCC patients was 60 months and 5 year survival was 64%. Tumor size greater than 6.5 cm, lymph node involvement (p=0.006) and metastasis in radiological results (p<0.001), lymphovascular invasion (p=0.015) and stage of disease (p<0.001) found to be significantly affecting the survival. Lymph node involvement in radiological results (p=0.0089; HR: 4.6; CI 95%: 1.4753-14.3523) and stage of the disease (p= 0.0129; HR: 1.6; CI 95%: 1.1087-2.3461) were affecting the survival independently.

CONCLUSION

We found radiological lymph node involvement and stage of the disease as independent factors affecting the survival of RCC patients after radical nephrectomy.

摘要

目的

评估术前影像学检查结果和术后病理检查结果对因肾细胞癌(RCC)行根治性肾切除术后患者生存的影响。

材料与方法

2007年12月至2014年1月期间,我们连续进行了159例根治性肾切除术。我们评估了年龄、性别、主诉、手术时间、合并症、计算机断层扫描(CT)和磁共振成像(MRG)结果。研究了肿块大小、淋巴结受累情况、肾静脉侵犯以及转移情况。在组织病理学检查中,特别寻找病理诊断、RCC亚型、淋巴结受累情况、淋巴管、神经周围侵犯以及包膜、肾盂侵犯和肾静脉受累情况。根据患者的死亡日期和研究时间段确定患者的随访期。

结果

124例(78%)患者患有RCC。RCC患者的平均估计生存期为60个月,5年生存率为64%。肿瘤大小大于6.5 cm、影像学检查结果中的淋巴结受累(p = 0.006)和转移(p < 0.001)、淋巴管侵犯(p = 0.015)以及疾病分期(p < 0.001)被发现对生存有显著影响。影像学检查结果中的淋巴结受累(p = 0.0089;HR:4.6;95%CI:1.4753 - 14.3523)和疾病分期(p = 0.0129;HR:1.6;95%CI:1.1087 - 2.3461)独立影响生存。

结论

我们发现影像学检查的淋巴结受累情况和疾病分期是影响根治性肾切除术后RCC患者生存的独立因素。

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