...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>BJU international >Outcome of nephron-sparing surgery for T1b renal cell carcinoma.
【24h】

Outcome of nephron-sparing surgery for T1b renal cell carcinoma.

机译：T1b肾细胞癌的保肾手术的结果。

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

OBJECTIVE: To present our experience with nephron-sparing surgery (NSS) for T1b renal cell carcinoma (RCC) in a high-volume tertiary referral centre. NSS for RCC of <4 cm (T1a) is increasingly accepted, although its role for RCC of 4-7 cm (T1b) remains controversial. PATIENTS AND METHODS: The records of 67 consecutive patients who had NSS for RCC of 4-7 cm at our institution were reviewed retrospectively. Data were collected on surgical indications, tumour characteristics, complications, changes in serum creatinine level, time to recurrence and time to death. Clinical progression-free survival (CPFS), overall survival (OS), cancer-specific survival (CSS) rates were estimated statistically. RESULTS: The mean patient age was 62 years. Surgical indications were absolute in 26 (39%) patients, relative in 11 (16%) and elective in 30 (45%). Two patients (3%) required postoperative embolization, and none developed a urinary fistula. Four patients (6%) had positive resection margins; none of these developed tumour recurrence. After a median (range) follow-up of 40.1 (1-98.3) months, 10 patients (15%) had died, of whom only one death was related to NSS (postoperative hypovolaemic shock). The tumour recurred in seven patients (10%) all of whom were alive at the last follow-up. Three patients (4%) developed a local recurrence and four (6%) developed locoregional or distant disease. The projected 5-year CPFS, CSS and OS rates were 84%, 99% and 72%, respectively. Seven (10%) patients developed de novo renal insufficiency. Elective and relative indications were not associated with a significant change in serum creatinine level (P = 0.22 and 0.10, respectively); in the absolute category this difference was statistically significant (P = 0.005). The main limitation is that the study was uncontrolled and retrospective, with a medium-term follow-up. CONCLUSIONS: This study showed the excellent surgical feasibility and CSS for NSS in T1b RCC. Local cancer control was achieved in the large majority of patients, with preservation of renal function in those with elective indications. Absolute indications significantly correlated with loss of renal function.
机译：目的：介绍我们在大容量三级转诊中心进行T1b肾细胞癌（RCC）的保肾术（NSS）的经验。尽管RSS在4-7 cm（T1b）的RCC中的作用仍然存在争议，但对于<4 cm（T1a）的RCC的NSS越来越被接受。病人和方法：回顾性分析本院67例连续7例RCS为4-7 cm的NSS患者。收集有关手术适应症，肿瘤特征，并发症，血清肌酐水平变化，复发时间和死亡时间的数据。统计估计了无进展生存期（CPFS），总生存期（OS），癌症特异性生存期（CSS）率。结果：平均患者年龄为62岁。手术指征在绝对患者中占26（39％），相对在11（16％）中，择期在30（45％）。两名患者（3％）需要术后栓塞治疗，无一例发生尿瘘。 4例患者（6％）的切缘阳性。这些都没有发展成肿瘤复发。在中位（范围）随访40.1（1-98.3）个月后，有10例患者（15％）死亡，其中只有1例死亡与NSS（术后血容量不足性休克）有关。肿瘤复发的七名患者（10％）在最后一次随访中都还活着。 3例（4％）发生局部复发，4例（6％）发生局部或远处疾病。预计的5年CPFS，CSS和OS比率分别为84％，99％和72％。七名（10％）患者出现了新的肾功能不全。选择性和相对适应证与血清肌酐水平的显着变化无关（分别为P = 0.22和0.10）;在绝对类别中，此差异具有统计学意义（P = 0.005）。主要局限性在于该研究不受控制且具有回顾性，需要进行中期随访。结论：本研究显示了T1b RCC中NSS的优良手术可行性和CSS。在大多数患者中实现了局部癌症控制，在有选择性适应症的患者中保留了肾功能。绝对适应症与肾功能丧失显着相关。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号