偶发性与症状性肾肿瘤：生存结果

Incidental vs symptomatic renal tumours: Survival outcomes.

作者信息

Al-Marhoon Mohammed S, Osman Ahmed Mosbah, Kamal Mohammed M, Shokeir Ahmed A

机构信息

Sultan Qaboos University, Oman.

Urology and Nephrology Center, Mansoura, Egypt.

出版信息

Arab J Urol. 2011 Mar;9(1):17-21. doi: 10.1016/j.aju.2011.03.006. Epub 2011 May 6.

DOI:10.1016/j.aju.2011.03.006

PMID:26579261

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4149050/

Abstract

PURPOSE

Currently there is an increase in the incidental diagnosis of renal cell carcinoma (RCC). Our aim was to assess the survival of patients with incidental and symptomatic renal tumours who had undergone nephrectomy.

PATIENTS AND METHODS

We retrospectively assessed 604 patients who underwent renal surgery for RCC between 1983 and 2005. Patients were divided in two groups; group 1 had incidental and group 2 had symptomatic tumours. The median follow-up was 4 and 3.3 years for groups 1 and 2, respectively. All patients had surgery in the form of radical or partial nephrectomy. Sex, age, tumour size, type of surgery, pathological characteristics and patient survival in both groups were evaluated. The statistical analysis included the log-rank, Kaplan-Meier and Cox regression tests.

RESULTS

There were 85 patients (14%) in group 1 (mean age 49.6 years) and 519 (86%) in group 2 (mean age 50 years). The mean (SEM, range) tumour size was 7.4 (0.4, 1.5-20) cm in group 1 and 9.7 (0.2, 2-38) cm in group 2 (P < 0.001). The most common stage was T1 (52%) and T2 (44%) in groups 1 and 2, respectively, with a predominance of G2 grade and the conventional type histology in both the groups. There was a significant difference in cancer-specific survival (CSS) between the groups (log-rank, P = 0.017). The 5- and 10-year CSS was 94% and 94% for group 1, and 82.5% and 79.5% for group 2. Cox regression analysis showed that in group 1, only the tumour mid-zonal location (P = 0.093), tumour stage pT (P < 0.001), grade 1 (P = 0.03), grade 2 (P = 0.01), grade 4 (P = 0.01) and the papillary histological type (P = 0.019) had significant effects on CSS. In group 2, only tumour size (P = 0.022) and stage pN (P = 0.003) had significant effects on CSS. The tumour recurrence rate was 18% and 29% for groups 1 and 2, respectively.

CONCLUSIONS

This large study supports the findings of other smaller studies published previously, confirming that at presentation incidental renal tumours are smaller and their diagnosis provides a better prognosis and longer CSS.

摘要

目的

目前肾细胞癌（RCC）的偶然诊断有所增加。我们的目的是评估接受肾切除术的偶然发现和有症状肾肿瘤患者的生存率。

患者与方法

我们回顾性评估了1983年至2005年间因RCC接受肾脏手术的604例患者。患者分为两组；第1组为偶然发现的肿瘤，第2组为有症状的肿瘤。第1组和第2组的中位随访时间分别为4年和3.3年。所有患者均接受了根治性或部分肾切除术。评估了两组患者的性别、年龄、肿瘤大小、手术类型、病理特征和患者生存率。统计分析包括对数秩检验、Kaplan-Meier检验和Cox回归检验。

结果

第1组有85例患者（14%）（平均年龄49.6岁），第2组有519例患者（86%）（平均年龄50岁）。第1组肿瘤平均（标准误，范围）大小为7.4（0.4，1.5 - 20）cm，第2组为9.7（0.2，2 - 38）cm（P < 0.001）。第1组和第2组最常见的分期分别为T1（52%）和T2（44%），两组中G2级和传统组织学类型占主导。两组之间的癌症特异性生存率（CSS）有显著差异（对数秩检验，P = 0.017）。第1组的5年和10年CSS分别为94%和94%，第2组为82.5%和79.5%。Cox回归分析显示，在第1组中，只有肿瘤中区位置（P = 0.093）、肿瘤分期pT（P < 0.001）、1级（P = 0.03）、2级（P = 0.01）、4级（P = 0.01）和乳头状组织学类型（P = 0.019）对CSS有显著影响。在第2组中，只有肿瘤大小（P = 0.022）和分期pN（P = 0.003）对CSS有显著影响。第1组和第2组的肿瘤复发率分别为18%和29%。