Watanabe M, Kitamura Y, Komatsubara S, Sakata Y
Department of Urology, Niigata Cancer Center Hospital.
Hinyokika Kiyo. 1995 Nov;41(11):847-53.
The clinical experience with 29 renal cell carcinoma patients who underwent resection of their metastatic lesions was reviewed. Fourteen patients had no metastatic lesions when nephrectomy was performed initially (initial M0 group) and 15 patients already had detected metastases at diagnosis of their renal tumors (initial M1 group). The final point of follow-up was May 31, 1994. Eighteen patients (M0 9, M1 9) were curatively resected and 11 (M0 5, M1 6) underwent non-curative resection. In the curatively resected group, 7 patients (3 lung, 2 adrenal gland, 1 brain, 1 bone metastasis) were alive with no recurrence followed from 50 to 174 months. Eight died from tumor recurrences, 1 was alive with tumor recurrence and 2 died from other diseases. The 3-year and 5-year survival rates in the curatively resected group (16 patients, excluding 2 who died from other diseases) were 87.5% and 61.9%, respectively, according to the Kaplan-Meier method. On the other hand, the 3-year and 5-year survival rate in the non-curatively resected group were 36.4% and 27.3%, respectively. Between the curatively resected group and non-curatively resected group, a significant difference was shown concerning the survival rate (3 year: P = 0.0018, 5 year: P = 0.003, generalized Wilcoxon method). We concluded that curative resection was the most important prognostic factor in the treatment of metastatic lesions.
回顾了29例接受转移性病灶切除术的肾细胞癌患者的临床经验。14例患者在初次行肾切除术时无转移性病灶（初始M0组），15例患者在肾肿瘤诊断时已检测到转移（初始M1组）。随访的最后时间点为1994年5月31日。18例患者（M0组9例，M1组9例）接受了根治性切除，11例（M0组5例，M1组6例）接受了非根治性切除。在根治性切除组中，7例患者（3例肺部、2例肾上腺、1例脑部、1例骨转移）存活且无复发，随访时间为50至174个月。8例死于肿瘤复发，1例带瘤存活，2例死于其他疾病。根据Kaplan-Meier法，根治性切除组（16例患者，不包括2例死于其他疾病的患者）的3年和5年生存率分别为87.5%和61.9%。另一方面，非根治性切除组的3年和5年生存率分别为36.4%和27.3%。根治性切除组和非根治性切除组之间的生存率存在显著差异（3年：P = 0.0018，5年：P = 0.003，广义Wilcoxon法）。我们得出结论，根治性切除是转移性病灶治疗中最重要的预后因素。
