Malek R S, Utz D C, Culp O S
J Urol. 1976 Nov;116(5):553-6. doi: 10.1016/s0022-5347(17)58908-9.
Twenty patients with renal cell carcinoma in anatomically or functionally solitary kidneys were treated and followed for up to 18 years. Factors pertinent to management and survival of these patients and 66 other well documented similar patients reported in the literature are analyzed. Most of the patients were unusually young and a significant number had had nephrectomy for contralateral renal cell carcinoma. Survival was closely related to the earlier presence of malignant disease in the other kidney, the duration of the interval between detection of the 2 neoplasms and the stage of the lesion in the solitary kidney. Partial nephrectomy has been the most successful treatment. The mean survival in the Mayo Clinic series has been 6 years for patients still alive and 2.4 years for those dead at the time of this analysis. Results in this and other series emphasize the importance of thorough long-term followup after nephrectomy for hypernephroma and of aggressive therapy when the remaining kidney becomes involved. It is foolhardy to abandon hope merely because there is a malignant tumor in a solitary kidney.
对20例解剖学或功能上为孤立肾的肾细胞癌患者进行了治疗并随访长达18年。分析了与这些患者以及文献中报道的其他66例有充分记录的类似患者的治疗和生存相关的因素。大多数患者异常年轻，相当一部分患者因对侧肾细胞癌接受了肾切除术。生存与另一肾中恶性疾病的早期存在、两个肿瘤检测之间的间隔时间以及孤立肾中病变的分期密切相关。部分肾切除术一直是最成功的治疗方法。在梅奥诊所系列中，仍存活患者的平均生存期为6年，在本次分析时死亡患者的平均生存期为2.4年。本系列及其他系列的结果强调了肾切除术后对肾上腺瘤进行全面长期随访的重要性，以及当剩余肾脏受累时积极治疗的重要性。仅仅因为孤立肾中有恶性肿瘤就放弃希望是愚蠢的。
