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肾细胞癌——血管梗死

Renal cell carcinoma--angioinfarction.

作者信息

Mebust W K, Weigel J W, Lee K R, Cox G G, Jewell W R, Krishnan E C

出版信息

J Urol. 1984 Feb;131(2):231-5. doi: 10.1016/s0022-5347(17)50320-1.

Abstract

In our experience the mortality rate in 46 patients who underwent angioinfarction for renal cell carcinoma was 4 per cent. Fever, ileus and leukocytosis were noted in 86 to 90 per cent of our patients. The use of absolute ethanol as a medium for renal infarction was associated with a significant incidence of damage to other organs. A 30 per cent decrease in tumor volume following angioinfarction using absorbable gelatin sponge and Gianturco coils was noted in 75 per cent of the patients. There was no evidence of metastatic tumor reduction and we could not document any significant decrease in operative time or blood loss. It would appear that there is some increased survival rate in patients with metastasis who are given adjuvant immune ribonucleic acid therapy. However, the numbers in our series are not significant to draw any definite conclusion. It is apparent that patients treated with infarction, delayed nephrectomy and medroxyprogesterone acetate did not have any significant survival over those treated with palliative nephrectomy or chemotherapy. The macrophage maturation assay may be useful during clinical followup.

摘要

根据我们的经验,46例因肾细胞癌接受血管梗死治疗的患者死亡率为4%。我们86%至90%的患者出现发热、肠梗阻和白细胞增多。使用无水乙醇作为肾梗死介质会导致其他器官受损的发生率显著增加。在75%的患者中,使用可吸收明胶海绵和吉安蒂尔科弹簧圈进行血管梗死后,肿瘤体积减少了30%。没有证据表明转移瘤减少,我们也无法证明手术时间或失血量有任何显著减少。接受辅助免疫核糖核酸治疗的转移患者似乎生存率有所提高。然而,我们系列中的病例数不足以得出任何明确结论。显然,接受梗死、延迟肾切除术和醋酸甲羟孕酮治疗的患者与接受姑息性肾切除术或化疗的患者相比,生存率没有显著差异。巨噬细胞成熟试验在临床随访中可能有用。

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