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肾细胞癌骨转移患者的临床特征与预后

[Clinical characteristics and prognosis of renal cell carcinoma patients with bone metastases].

作者信息

Zhai J P, Liu N, Wang H, Wang H D, Man L B

机构信息

Department of Urology, Beijing Jishuitan Hospital, Beijing 100096, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Apr 14;100(14):1068-1071. doi: 10.3760/cma.j.cn112137-20190809-01784.

Abstract

To determine the status of bone metastasis (BM) and prognosis factors of patients with renal cell carcinoma (RCC) in our center. The clinical and medical records of RCC patients with BM, who were admitted to the Department of Urology, Bone Oncology and Spine Surgery, Beijing Jishuitan Hospital from August 2009 to August 2017 were collected. The gender, age, time of BM, location of BM, numbers of BM, presence or absence of visceral metastasis, pathological types of BM were investigated. The patients were followed up regularly, and the survival curves were analyzed by Kaplan-Meier method. Cox proportional hazard regression model was used to estimate the prognostic factors. A total of 51 RCC patients with bone metastasis were collected. The age of patients ranged from 38 to 76 (58.6±8.2) years old, including 39 males (76.5%) and 12 females (23.5%). The ratio of male to female was 3.25∶1. The patients were followed up for 8 to 109 months, with a median follow-up time of 30 months. The follow-up rate was 90.2%. Thirty-one (60.8%) patients died at the last follow-up, with a median overall survival (OS) time of 25 months. The median OS was 38 months and 20 months in the solitary BM group (26 cases, 51.0%) and BM ≥ 2 group (25 cases, 49.0%), respectively. The difference between the two groups was statistically significant (0.021). The median OS was 30 months, 69 months and 17 months in the axis BM group (22 cases, 43.1%), appendicular BM group (19 cases, 37.3%) and both the axis and appendicular BM group (10 cases, 19.6%), respectively. The difference between the groups was statistically significant (0.012). The median OS was 22 months and 38 months in the patients with (15 cases, 29.4%) and without (36 cases, 70.6%) visceral metastases groups, respectively. The difference between the two groups was statistically significant (0.007). Univariate and multivariate Cox regression analysis showed that the numbers of BM (=3.130, 95: 1.502-6.520, 0.035) and visceral metastasis (=4.699, 95: 1.810-9.545, 0.001) were independent prognostic factors for RCC with BM. Solitary BM, no visceral metastasis are good prognostic factors for RCC with BM. For these patients, radical resection of BM is feasible to improve survival rate.

摘要

确定我院肾细胞癌(RCC)患者骨转移(BM)情况及预后因素。收集2009年8月至2017年8月在北京积水潭医院泌尿外科、骨肿瘤科及脊柱外科住院的RCC骨转移患者的临床及病历资料。调查患者的性别、年龄、骨转移时间、骨转移部位、骨转移数量、有无内脏转移、骨转移的病理类型。对患者进行定期随访,采用Kaplan-Meier法分析生存曲线。采用Cox比例风险回归模型评估预后因素。共收集51例RCC骨转移患者。患者年龄38~76岁(58.6±8.2岁),其中男性39例(76.5%),女性12例(23.5%)。男女比例为3.25∶1。患者随访8~109个月,中位随访时间30个月。随访率为90.2%。31例(60.8%)患者在末次随访时死亡,中位总生存(OS)时间为25个月。单发骨转移组(26例,5

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