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细胞减灭性肾切除术在伴肝转移的肾细胞癌患者中的作用。

The role of cytoreductive nephrectomy in renal cell carcinoma patients with liver metastasis.

机构信息

Department of Urology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China; Graduate School of Peking Union Medical College, Beijing, China.

Department of Andrology, Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

Bosn J Basic Med Sci. 2021 Apr 1;21(2):229-234. doi: 10.17305/bjbms.2020.4896.

Abstract

It is widely accepted that renal cell carcinoma (RCC) with liver metastasis (LM) carries a dismal prognosis. We aimed to explore the value of cytoreductive nephrectomy among these patients. Patients were extracted from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2017. The univariate and multivariate Cox proportional hazards models were conducted to select the prognostic predictors of survival. Patients were divided into nephrectomy and non-nephrectomy groups. Propensity score-matching (PSM) analyses were applied to reduce the above factors' differences between the groups. Overall survival (OS) was compared by Kaplan-Meier analyses. Data from 683 patients were extracted from the database. The univariate Cox regression and multivariate Cox regression revealed that factors including age, histologic type, T and N stages, lung metastasis, brain metastasis, and nephrectomy were significant predictors of survival in the patients. After the PSM analyses, we found that nephrectomy prolonged OS. Nephrectomy can prolong OS in eligible RCC patients with LM.

摘要

普遍认为,伴肝转移的肾细胞癌(RCC)预后较差。我们旨在探讨细胞减灭性肾切除术在这些患者中的价值。患者数据从 2010 年至 2017 年的监测、流行病学和最终结果(SEER)数据库中提取。采用单因素和多因素 Cox 比例风险模型来选择生存的预后预测因素。将患者分为肾切除术组和非肾切除术组。采用倾向评分匹配(PSM)分析来减少两组间上述因素的差异。通过 Kaplan-Meier 分析比较总生存期(OS)。从数据库中提取了 683 名患者的数据。单因素 Cox 回归和多因素 Cox 回归显示,年龄、组织学类型、T 和 N 分期、肺转移、脑转移和肾切除术是影响患者生存的显著预测因素。经过 PSM 分析,我们发现肾切除术可延长 OS。在符合条件的伴 LM 的 RCC 患者中,肾切除术可延长 OS。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41bd/7982060/6f5a77e891f8/BJBMS-21-229-g001.jpg

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