透明细胞乳头状肾细胞肿瘤的临床特征和手术结果：前瞻性队列研究结果。
Clinical features and Surgical Outcome of Clear Cell Papillary Renal Cell Tumor: result from a prospective cohort.
机构信息
Department of Urology, Seoul National University Hospital, Seoul, Korea.
Department of Urology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
出版信息
BMC Urol. 2023 Mar 21;23(1):41. doi: 10.1186/s12894-023-01216-7.
BACKGROUND
Clear cell papillary renal cell tumor (CCPRCT) was first reported in 2006 a patient with end stage renal disease. After that it was discovered in the kidney without end stage renal disease in the 2010s and started to be mentioned in pathology and urology. The incidence of CCPRCT is low and most of it is discovered incidentally, so there is a lack of reports on clinical characteristics and surgical outcome.
METHODS
This study used clinical data from the Seoul National University Prospectively Enrolled Registry for Renal Cell Carcinoma-Nephrectomy (SUPER-RCC-Nx). Between August 2016 and July 2022, patients who underwent radical or partial nephrectomy with clear cell papillary RCC with pathological finding were included in this study. All patients' pathologic reports were reviewed by 1 pathologist. Clinical characteristics and surgical outcomes were presented through descriptive statistics, and Kaplan-Meier curve used for survival analysis.
RESULTS
Of the 2057 patients, CCPRCT was reported in 36 patients (1.8%). The median follow up period was 26.8 months. The median age was 67 years, and there were 10 females and 26 males. The median tumor size was 1.2 cm. Twenty-nine patients underwent partial nephrectomy. Seven patients with end-stage renal disease underwent radical nephrectomy. The median operative time for patients who underwent partial nephrectomy was 97.5 min and the estimated blood loss was 100 cc. The median hospital days was 4 and 30-day complications were 2 cases with clavien-dindo classification III or higher. During the follow-up period, there was no recurrence and cancer specific mortality.
CONCLUSIONS
The size of CCPRCT was small and there was no advanced stage at that time of diagnosis. There was no recurrence or cancer specific mortality during the follow-up period. A multi-center study with a large scale is needed in the future.
TRIAL REGISTRATION
Seoul National University Hospital (SNUH) Institutional Review Board (IRB) (approval number: 2210-126-1371).
背景
透明细胞乳头状肾细胞肿瘤（CCPRCT）于 2006 年首次在一名终末期肾病患者中报道。此后，在 21 世纪 10 年代在无终末期肾病的肾脏中发现了该肿瘤，并开始在病理学和泌尿科中提及。CCPRCT 的发病率较低，大多数是偶然发现的，因此缺乏关于临床特征和手术结果的报道。
方法
本研究使用了首尔国立大学前瞻性肾细胞癌肾切除术登记处（SUPER-RCC-Nx）的临床数据。2016 年 8 月至 2022 年 7 月期间，对接受根治性或部分肾切除术并伴有透明细胞乳头状 RCC 的病理发现的患者进行了本研究。所有患者的病理报告均由 1 名病理学家进行了复查。通过描述性统计数据展示了临床特征和手术结果，并使用 Kaplan-Meier 曲线进行了生存分析。
结果
在 2057 名患者中，有 36 名（1.8%）报告了 CCPRCT。中位随访时间为 26.8 个月。中位年龄为 67 岁，女性 10 例，男性 26 例。中位肿瘤大小为 1.2cm。29 例患者接受了部分肾切除术。7 例终末期肾病患者接受了根治性肾切除术。行部分肾切除术的患者的中位手术时间为 97.5 分钟，估计失血量为 100cc。中位住院天数为 4 天，30 天并发症为 2 例，Clavien-Dindo 分级 III 或更高。在随访期间，无复发和癌症特异性死亡。
结论
CCPRCT 的体积较小，且在诊断时没有晚期阶段。在随访期间无复发或癌症特异性死亡。未来需要进行一项多中心、大规模的研究。
试验注册
首尔国立大学医院（SNUH）机构审查委员会（IRB）（批准号：2210-126-1371）。
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