Chen Jinchao, Qi Nienie, Zhu Shaoxing
Department of Urologic Surgery, The Cancer Hospital of the University of Chinese Academy of Sciences/Zhejiang Cancer Hospital, Institute of Basic Medicine and Cancer (IBMC), Chinese Academy of Sciences, Hangzhou, China.
Department of Urology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
Front Oncol. 2021 Feb 19;10:632221. doi: 10.3389/fonc.2020.632221. eCollection 2020.
In addition to being rare, metastases to the kidney present clinicians with issues regarding their treatment.
We retrospectively analyzed 35 cases of diagnosed renal metastases. The clinical characteristics, imaging features, pathological features, diagnosis, and treatment were analyzed, and Kaplan-Meier methods and Cox regression analysis were used to calculate overall survival (OS) and influencing factors.
The average age of the patients was 62 years, and 40% presented with symptoms. The most common primary tumor was lung cancer (60%), and two patients had renal metastases coexisting with renal cell carcinoma. The average interval from primary tumor to renal metastasis was 29.4 months. Only 45.5% of the patients who underwent enhanced computerized tomography were diagnosed with renal metastases. Renal biopsy was performed in 16 patients (45.7%), leading to a diagnosis in 15 (93.8%). Twenty-one patients (60%) received surgical treatment, and median recurrence free survival of these patients was 7 months (95% CI, 5 to 12). Overall, the median OS was 44 months for patients who underwent renal surgery, and 52 months for patients who did not (P = 0.672). However, for patients without metastases at other sites, surgery could significantly prolong OS (P = 0.001).
Although rare, the possibility of renal metastasis should be considered after finding renal tumors in patients with primary tumors in other organs, and can be diagnosed by imaging examination and puncture biopsy. For patients without other metastases, surgical intervention can be considered for the renal lesions.
肾转移瘤除了罕见外，还给临床医生带来了治疗方面的问题。
我们回顾性分析了35例确诊的肾转移瘤病例。分析了其临床特征、影像学特征、病理特征、诊断和治疗情况，并采用Kaplan-Meier方法和Cox回归分析来计算总生存期（OS）及影响因素。
患者的平均年龄为62岁，40%出现症状。最常见的原发肿瘤是肺癌（60%），两名患者肾转移瘤与肾细胞癌共存。从原发肿瘤到肾转移的平均间隔时间为29.4个月。增强计算机断层扫描的患者中只有45.5%被诊断为肾转移瘤。16例患者（45.7%）进行了肾活检，其中15例（93.8%）得以确诊。21例患者（60%）接受了手术治疗，这些患者的无复发生存期中位数为7个月（95%CI，5至12）。总体而言，接受肾手术的患者的OS中位数为44个月，未接受手术的患者为52个月（P = 0.672）。然而，对于其他部位无转移的患者，手术可显著延长OS（P = 0.001）。
尽管罕见，但在其他器官有原发肿瘤的患者发现肾肿瘤后应考虑肾转移的可能性，可通过影像学检查和穿刺活检进行诊断。对于无其他转移的患者，可考虑对肾病变进行手术干预。
