目的：通过对肾癌脊椎体转移患者的临床表现、影像学表现、治疗经过和预后的分析，探索手术治疗的意义。方法2003-2013年22例肾癌脊椎体转移患者行手术治疗,通过回顾性分析和总结22例患者的随访资料，对肾癌脊椎体转移患者的治疗方案的选择进行探讨。结果22例肾癌脊椎体转移患者，男18例（81.8%），女4例（18.2%）,平均年龄52岁（25~78岁）。术前患者均接受了原发肾癌的肾切除术。术前和术后部分患者行放疗、化疗或靶向治疗。伴有脊髓损伤的患者术后Frankel评分有不同程度提高。术后平均随访时间28个月（12~84个月）。在随访过程中，14例患者死亡，其余8例患者随访至今情况良好，未见明显复发征象。结论对伴有脊髓损伤的肾癌脊椎体转移患者，脊椎体转移瘤切除减压内固定术治疗可缓解或改善患者的脊髓神经功能，提高生存质量，对于压迫时间短，压迫程度轻的患者的改善更明显。与既往资料比较，手术可能延长肾癌脊椎体转移患者的生存时间，尚不能认为放化疗或靶向治疗能延长肾癌脊椎体转移患者的寿命。%Objective The aim of this study is to discuss the clinical presentation,imaging f indings,treatments received,and outcome of therapies for patients with spinal metastasis of renal cell carcinoma,with the goal of emphasizing the importance of surgery in this setting and discussing therapeutic plan for treating these patients. Methods A total of 22 patients with spinal metastasis of renal cell carcinoma who received surgery in our department were identified from 2002 to 2013. The series of 22 patients collected from our institution over the past 11 years were used to discuss treatment options for spinal metastasis of renal cell carcinoma on the basis of follow-up data. Results Twenty-two patients were identified for our study ,18 males(81.8%),4 females(18.2%).The mean age of the patients in this study was 52 years(range 25~78 years). The patients with spinal cord injury attained improvement of the Frankel classification after surgery. The average follow-up duration of the patients in this study was 28 months(range 12~84 months). Fourteen patients died during follow-up,all other patients maintained a disease-free status during follow-up. Conclusions As spinal metastasis of renal cell carcinoma with spinal cord injury,Dorsal spinal decompression through curettage and stabilization can preserve or restore neurological function for most patients. It is more obvious for improvement of the quality of life of the patients who suffer spinal cord compression short and mild. Compared with previous data,surgery may prolong the survival time of spinal metastasis of renal cell carcinoma,but it could not conclude that chemotherapy,radiotherapy and targeted therapy can prolong the survival time of spinal metastasis of renal cell carcinoma.
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