Tanguay S, Pisters L L, Lawrence D D, Dinney C P
Department of Urology, University of Texas M. D. Anderson Cancer Center, Houston 77030, USA.
J Urol. 1996 Jan;155(1):26-9.
We evaluated the outcome of patients with locally recurrent renal cell carcinoma treated at our university.
We retrospectively analyzed 16 cases of locally recurrent renal cell carcinoma in the renal fossa treated with surgical resection alone or in combination with biological therapy.
Complete resection was possible in 15 patients of whom 3 had positive surgical margins. Of the 12 patients with negative margins 6 are free of disease while the 3 with positive margins had involvement of a remaining ipsilateral adrenal gland and distant metastasis. Of all 16 patients 12 are alive a median of 23.5 months after the diagnosis of locally recurrent renal cell carcinoma. Of those treated with the combination of biological therapy and surgery 50% have no evidence of disease compared to 25% of those treated with surgery alone.
Long-term survival can be achieved with an aggressive surgical approach. Incomplete resection or positive surgical margins are associated with a high risk of local or distant failure, and combined treatment with immunotherapy and surgery may offer a benefit compared to surgery alone.
我们评估了在我校接受治疗的局部复发性肾细胞癌患者的治疗结果。
我们回顾性分析了16例肾窝局部复发性肾细胞癌患者，这些患者接受了单纯手术切除或联合生物治疗。
15例患者实现了完全切除，其中3例手术切缘阳性。在切缘阴性的12例患者中，6例无疾病复发，而切缘阳性的3例患者同侧肾上腺残留受累且发生远处转移。16例患者中，12例存活，自诊断局部复发性肾细胞癌后中位生存期为23.5个月。接受生物治疗与手术联合治疗的患者中，50%无疾病复发迹象，而单纯接受手术治疗的患者这一比例为25%。
积极的手术方法可实现长期生存。不完全切除或手术切缘阳性与局部或远处复发的高风险相关，与单纯手术相比，免疫治疗与手术联合治疗可能更有益。
