Althausen P, Althausen A, Jennings L C, Mankin H J
Orthopaedic Service, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA.
Cancer. 1997 Sep 15;80(6):1103-9.
The purpose of this study was to analyze the survival of 38 cases of metastatic renal cell carcinoma with secondary osseous metastases treated at the Orthopaedic Oncology Unit of the Massachusetts General Hospital. The survival was analyzed because it seemed to be considerably longer than any reported previously in the literature.
Survival was analyzed with respect to age, gender, site of primary tumor, presence of pathologic fracture, disease free interval, initial presentation with metastasis, solitary versus multiple metastases, and axial versus appendicular metastases.
Survival for the entire group was 90% at 6 months, 84% at 1 year, 55% at 5 years, and 39% at 10 years. Age, gender, and presence of pathologic fracture had no influence on survival. Presentation without metastases, long disease free interval between nephrectomy and first metastases, appendicular skeletal location, and solitary metastases were all correlated with longer survival.
In the authors' view, patients with the characteristics correlated with longer survival are appropriate candidates for aggressive surgical resection of bone metastasis.
本研究旨在分析麻省总医院骨肿瘤科室收治的38例发生继发性骨转移的转移性肾细胞癌患者的生存情况。对生存情况进行分析是因为其似乎比以往文献报道的要长得多。
从年龄、性别、原发肿瘤部位、病理性骨折情况、无病间期、初次出现转移的情况、单发与多发转移以及轴向与附属骨骼转移等方面对生存情况进行分析。
整个组6个月时的生存率为90%，1年时为84%，5年时为55%，10年时为39%。年龄、性别和病理性骨折情况对生存无影响。初次就诊时无转移、肾切除与首次转移之间的无病间期长、附属骨骼部位以及单发转移均与较长的生存期相关。
作者认为，具有与较长生存期相关特征的患者适合积极手术切除骨转移灶。
