Al Saidi Ibrahim Khalid, Alqasem Kholoud Saleh, Gharaibeh Saeda Turki, Qamhia Naim Z N, Abukhiran Ibrahim, Al-Daghmin Ali Ahmad
King Hussein Cancer Center, Amman, Jordan.
Turk J Urol. 2017 Mar;43(1):42-47. doi: 10.5152/tud.2016.33667. Epub 2017 Jan 6.
Use of partial nephrectomy (PN) for renal tumors appears to have relatively lower incidence rates in Jordan. We sought to characterize its trend at King Hussein Cancer Center for the last 10 years.
A retrospective review of our renal cell cancer data was performed. We identified 169 patients who had undergone surgery for renal tumors measuring ≤7 cm between 2005 and 2015. We characterized tumor size, pathology, type of surgery and clinical outcomes. Factors associated with the use of PN were evaluated using univariable and multivariable logistic regression models.
Of the 169 patients, 34 (20%) and 135 (80%) had undergone partial and radical nephrectomy (RN) respectively for tumors ≤7 cm in diameter. Total number of 48 patients with tumors of ≤4 cm in diameter had undergone either PN (n=19; 40%) or RN (n=29; 60%). The frequency of PN procedures steadily increased over the years from 6% in 2005-2008, to 32% in 2013-2015, contrary to RN which was less frequently applied 94% in 2005-2008, and 68% in 2013-2015. In multivariable analysis, delayed surgery (p=0.01) and smaller tumor size (p=0.0005) were significant independent predictors of PN. During follow-up period, incidence of metastasis was lower in PN versus RN (13% and 32%, respectively, p=0.043). Local recurrence rates were not significantly different between PN (6.9%) and RN (7.2%) (p=0.99). The mean tumor sizes for patients who had undergone PN and RN were 4.1 and 5.5 cm respectively, (p<0.0001). The mean follow-up period for PN was 20 months, and for RN 33 months, (p=0.0225).
Partial nephrectomy for small renal tumors is relatively less frequently applied in Jordan, however an increase in its use has been observed over the years. Our data showed lower rates of distant metastasis and similar rates of local recurrence in favor of PN.
在约旦，肾肿瘤采用部分肾切除术（PN）的发生率似乎相对较低。我们试图描述过去10年侯赛因国王癌症中心（King Hussein Cancer Center）的这一趋势。
对我们的肾细胞癌数据进行回顾性分析。我们确定了2005年至2015年间169例接受手术治疗的肾肿瘤患者，肿瘤直径≤7 cm。我们对肿瘤大小、病理、手术类型和临床结果进行了描述。使用单变量和多变量逻辑回归模型评估与PN使用相关的因素。
在这169例患者中，分别有34例（20%）和135例（80%）因直径≤7 cm的肿瘤接受了部分肾切除术（PN）和根治性肾切除术（RN）。直径≤4 cm的肿瘤患者共有48例，其中19例（40%）接受了PN，29例（60%）接受了RN。多年来，PN手术的频率稳步上升，从2005 - 2008年的6%升至2013 - 2015年的32%，而RN的应用频率则相反，2005 - 2008年为94%，2013 - 2015年为68%。在多变量分析中，延迟手术（p = 0.01）和较小的肿瘤大小（p = 0.0005）是PN的显著独立预测因素。在随访期间，PN组的转移发生率低于RN组（分别为13%和32%，p = 0.043）。PN组（6.9%）和RN组（7.2%）的局部复发率无显著差异（p = 0.99）。接受PN和RN的患者的平均肿瘤大小分别为4.1 cm和5.5 cm（p < 0.0001）。PN组的平均随访期为20个月，RN组为33个月（p = 0.0225）。
约旦对小肾肿瘤行部分肾切除术的应用相对较少，但多年来其使用有所增加。我们的数据显示，PN组远处转移率较低，局部复发率相似，支持PN手术。
