临床局限性肾细胞癌肾切除术延长等待时间的安全性
Safety of Prolonged Wait Time for Nephrectomy for Clinically Localized Renal Cell Carcinoma.
作者信息
Qi Nienie, Zhao Fangzheng, Liu Xiaoxiao, Wei Wei, Wang Junqi
机构信息
Department of Urology, The Affiliated Hospital of Xuzhou Medical University. Xuzhou Medical University, Xuzhou, China.
Department of Radiation Oncology, Cancer Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China.
出版信息
Front Oncol. 2021 Mar 30;11:617383. doi: 10.3389/fonc.2021.617383. eCollection 2021.
BACKGROUND
There is usually a surgical wait time before nephrectomy for patients with clinically localized renal cell carcinoma, and many factors can influence this preoperative wait time. A relatively prolonged wait time may cause tumor progression. Therefore, we assessed the effect of preoperative wait time on the prognosis of patients with clinically localized renal cell carcinoma.
METHODS
The outcomes of 561 patients with clinically localized renal cell carcinoma who underwent nephrectomy between July 2011 and March 2017 were retrospectively evaluated. According to the wait time before surgery, we divided the patients into three groups: short-wait group (≤ 30 days), intermediate-wait group (> 30 and ≤ 90 days), and long-wait group (>90 days). The clinicopathological characteristics were evaluated, and the survival rates of the three groups were compared.
RESULTS
This study included 370 male (66%) and 191(34%) female patients, with a median age of 64 years. There were 520 patients with stage T1 and 41 patients with stage T2 tumors. The median interval between diagnosis and surgery was 21 days. There were no significant differences in age, sex, Eastern Cooperative Oncology Group (ECOG) performance status, body mass index, tumor size, surgical approach, surgical procedure, pathological subtype, tumor stage, tumor grade, and residual tumor among the three groups. Overall survival(OS) and cancer-specific survival (CSS) were comparable; the 5-year OS of the short-, intermediate-, and long-wait time groups were 84.2%, 82.0%, and 89.8%, respectively (P=0.732). The 5-year CSS rates of the short-, intermediate-, and long-wait time groups were 87.1%, 88.9%, and 90.4%, respectively (P=0.896). Multivariate analysis revealed that wait time was not an independent prognostic factor for OS or CSS.
CONCLUSION
Prolonged surgical wait time (> 90 days) does not influence survival in patients with clinically localized renal cell carcinoma.
背景
对于临床局限性肾细胞癌患者，肾切除术之前通常存在手术等待时间，且许多因素可影响这一术前等待时间。相对较长的等待时间可能导致肿瘤进展。因此，我们评估了术前等待时间对临床局限性肾细胞癌患者预后的影响。
方法
回顾性评估2011年7月至2017年3月期间接受肾切除术的561例临床局限性肾细胞癌患者的结局。根据手术前的等待时间，我们将患者分为三组：短等待组（≤30天）、中等等待组（>30天且≤90天）和长等待组（>90天）。评估临床病理特征，并比较三组的生存率。
结果
本研究纳入370例男性（66%）和191例女性（34%）患者，中位年龄为64岁。有520例T1期患者和41例T2期肿瘤患者。诊断与手术之间的中位间隔时间为21天。三组患者在年龄、性别、东部肿瘤协作组（ECOG）体能状态、体重指数、肿瘤大小、手术入路、手术方式、病理亚型、肿瘤分期、肿瘤分级和残留肿瘤方面无显著差异。总生存期（OS）和癌症特异性生存期（CSS）具有可比性；短等待时间组、中等等待时间组和长等待时间组的5年OS分别为84.2%、82.0%和89.8%（P=0.732）。短等待时间组、中等等待时间组和长等待时间组的5年CSS率分别为87.1%、88.9%和90.4%（P=0.896）。多因素分析显示，等待时间不是OS或CSS的独立预后因素。
结论
延长的手术等待时间（>90天）不会影响临床局限性肾细胞癌患者的生存。
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