Plante Kyle, Stewart Telisa M, Wang Dongliang, Bratslavsky Gennady, Formica Margaret
State University of New York, Upstate Medical University, Syracuse, NY, USA.
Int Urol Nephrol. 2017 Aug;49(8):1375-1381. doi: 10.1007/s11255-017-1612-0. Epub 2017 May 26.
To provide updated treatment trends, determinants, and survival of partial nephrectomy (PN) and radical nephrectomy (RN) across the USA.
Secondary data from the National Cancer Data Base (NCDB) participant user file from 2004 to 2013. The NCDB captures approximately 70% of all newly diagnosed cancer cases each year.
Multivariable logistic regression was used to estimate odds ratios for RN overall. Kaplan-Meier, multivariable Cox regression, and log-rank test were used to characterize patient survival.
Patients diagnosed with clinical stage I RCC who received either RN or PN as the primary surgical treatment were included.
The study consisted of 121,386 cases (PN = 57,016; RN = 64,370). The overall use of PN for stage I RCC increased by 24.2% over 9 years. An overall 5- and 10-year survival advantage was estimated following PN compared to RN; estimated overall risk of death was higher with RN.
The use of PN for stage I RCC has continued to increase and is associated with an overall survival advantage. Multivariable analysis showed that disparities exist among sociodemographic groups that are also associated with treatment type and survival.
提供美国各地部分肾切除术（PN）和根治性肾切除术（RN）的最新治疗趋势、决定因素和生存率。
2004年至2013年国家癌症数据库（NCDB）参与者用户文件中的二手数据。NCDB每年收集约70%的新诊断癌症病例。
采用多变量逻辑回归估计RN的总体优势比。采用Kaplan-Meier法、多变量Cox回归和对数秩检验来描述患者生存率。
纳入诊断为临床I期肾细胞癌且接受RN或PN作为主要手术治疗的患者。
该研究包括121386例病例（PN = 57016例；RN = 64370例）。9年间I期肾细胞癌PN的总体使用率增加了24.2%。与RN相比，PN术后估计有5年和10年的总体生存优势；RN的总体死亡风险估计更高。
I期肾细胞癌PN的使用持续增加，且与总体生存优势相关。多变量分析表明，社会人口学群体之间存在差异，这些差异也与治疗类型和生存率相关。
