Liu Hui, Kong Qing-Fang, Li Jian, Wu Yu-Qing, Pan Ke-Hao, Xu Bin, Wang Ya-Li, Chen Ming
Department of Urology, Binhai People's Hospital, Yancheng, China.
Department of Nosocomial Infection, Affiliated Zhongda Hospital of Southeast University, Nanjing, China.
Transl Androl Urol. 2021 Mar;10(3):1170-1178. doi: 10.21037/tau-20-1262.
Kidney cancer is the most common malignant tumor of the kidney in adults. However, in terms of the treatment for pT3a renal cell carcinoma (RCC), whether partial nephrectomy (PN) can be selected is still controversial. This study was conducted to compare the efficacy of PN and radical nephrectomy (RN) in treatment for patients with pT3a RCC.
The relative English databases including PubMed and EMBASE were searched for studies comparing PN and RN for pT3a RCC between 2010 and 2020. Stata 13.0 software was used to compare the cancer-specific survival (CSS), overall survival (OS), cancer-specific mortality (CSM), relapse-free survival (RFS), complications and positive surgical margin.
Nine articles were included with a total of 3,391 patients, of whom 2,113 received RN and 1,278 received PN. The results showed that there is no statistical difference in CSS, OS, CSM, RFS, complications and positive surgical margin between RN and PN. No heterogeneity was shown in study.
There were no differences in the CSS, OS, CSM, RFS, complications and positive surgical margin of the patients in RN and PN group. For pT3a RCC, RN did not provide a better survival benefit compared to PN. Considering PN can suppress the progression of tumor and reduce the risk of postoperative chronic renal insufficiency, we found PN is a good choice for pT3a RCC. However, further large-sample, studies are still needed in future.
肾癌是成人中最常见的肾脏恶性肿瘤。然而,对于pT3a期肾细胞癌(RCC)的治疗,是否可以选择部分肾切除术(PN)仍存在争议。本研究旨在比较PN和根治性肾切除术(RN)治疗pT3a期RCC患者的疗效。
检索包括PubMed和EMBASE在内的相关英文数据库,查找2010年至2020年间比较PN和RN治疗pT3a期RCC的研究。使用Stata 13.0软件比较癌症特异性生存率(CSS)、总生存率(OS)、癌症特异性死亡率(CSM)、无复发生存率(RFS)、并发症和手术切缘阳性情况。
纳入9篇文章,共3391例患者,其中2113例接受RN,1278例接受PN。结果显示,RN和PN在CSS、OS、CSM、RFS、并发症和手术切缘阳性方面无统计学差异。研究中未显示异质性。
RN组和PN组患者的CSS、OS、CSM、RFS、并发症和手术切缘阳性情况无差异。对于pT3a期RCC,与PN相比,RN并未提供更好的生存获益。考虑到PN可以抑制肿瘤进展并降低术后慢性肾功能不全的风险,我们发现PN是pT3a期RCC的一个不错选择。然而,未来仍需要进一步的大样本研究。