Yu Xiaoteng, Wang Bing, Li Xuesong, Lin Gang, Zhang Cuijian, Yang Yang, Fang Dong, Song Yi, He Zhisong, Zhou Liqun
Department of Urology, Peking University First Hospital, Institute of Urology, National Urological Cancer Center, Peking University, Beijing 100034, China.
Department of Orthopedics, Peking University First Hospital, Beijing 100034, China.
Biomed Res Int. 2015;2015:176373. doi: 10.1155/2015/176373. Epub 2015 Oct 11.
To investigate the efficacy of surgery in the treatment of metastatic renal cell carcinoma (mRCC) and to identify prognostic factors.
A single center retrospective study of 96 patients with mRCC from December 2004 to August 2013.
The median follow-up time was 45 months. Thirty-one (32.3%) of the patients received complete resection of metastatic sites, 11 (11.5%) of the patients underwent incomplete resection of metastatic sites, and 54 (56.3%) of the patients received no surgery. In the univariate Kaplan-Meier analysis, the median overall survival times of the three groups were 52 months, 16 months, and 22 months, respectively (p < 0.001). The difference in the overall survival time was statistically significant between complete resection and no surgery groups (HR = 0.43, p = 0.009), while there was no significant difference between the incomplete metastasectomy and no surgery groups (HR = 1.80, p = 0.102). According to the multivariate Cox regression analysis, complete metastasectomy (HR = 0.49, p = 0.033), T stage > 3 (HR = 1.88, p = 0.015), disease free interval <12 months (HR = 2.34, p = 0.003), and multiorgan involvement (HR = 2.00, p = 0.011) were significant prognostic factors.
In the era of targeted therapy, complete metastasectomy can improve overall survival. Complete metastasectomy, T stage > 3, disease free interval <12 months, and multiorgan involvement are independent prognostic factors.
探讨手术治疗转移性肾细胞癌（mRCC）的疗效并确定预后因素。
对2004年12月至2013年8月期间96例mRCC患者进行单中心回顾性研究。
中位随访时间为45个月。31例（32.3%）患者接受了转移灶的完整切除，11例（11.5%）患者接受了转移灶的不完全切除，54例（56.3%）患者未接受手术。在单因素Kaplan-Meier分析中，三组患者的中位总生存时间分别为52个月、16个月和二十2个月（p < 0.001）。完整切除组与未手术组的总生存时间差异具有统计学意义（HR = 0.43，p = 0.009），而不完全转移灶切除术组与未手术组之间无显著差异（HR = 1.80，p = 0.102）。根据多因素Cox回归分析，完整转移灶切除术（HR = 0.49，p = 0.033）、T分期>3（HR = 1.88，p = 0.015）、无病间期<12个月（HR = 2.34，p = 0.003）和多器官受累（HR = 2.00，p = 0.011）是显著的预后因素。
在靶向治疗时代，完整转移灶切除术可提高总生存率。完整转移灶切除术、T分期>3、无病间期<12个月和多器官受累是独立的预后因素。
