肾癌腔静脉转移的治疗方式及预后分析  

Treatment and Prognosis of Renal Cell Carcinoma with Vena Cava Tumor Thrombi

作　　者：孙星慧[1] 郑凯[1] 杨顺良[1] 吴卫真[1] 谭建明[1] 

机构地区：[1]南京军区福州总医院泌尿外科,福建福州350025

出　　处：《医学临床研究》2010年第11期2033-2034,2037,共3页Journal of Clinical Research

摘　　要：[目的]探讨肾癌合并静脉癌栓转移患者的治疗及预后情况.[方法]48例肾癌合并静脉癌栓转移患者,其中37例行根治性肾癌切除和癌栓切除术,11例（22.9%）有远处转移.用Kaplan-Meier 法计算肿瘤生存率.log rank 法分析各组生存率的差别.Cox回归模型分析影响肿瘤预后的因素.[结果]肾癌患者总的5年生存率为40.7%.癌栓水平：位于肾静脉6例（12.5%）,膈以下腔静脉29例（60.5%）,侵犯至膈以上腔静脉13例（27%）.各静脉癌栓水平患者的5年生存率无明显差异.无远处转移的5年生存率为56%,有远处转移的5年生存率为8%（P〈0.01）,二者有显著性差异.在无远处转移的癌栓患者中,行肾癌根治术及癌栓取出术者5年生存率为68.3%,未进行手术者5年生存率为18%（P〈0.01）,二者有显著性差异.[结论]远处转移是影响肾癌合并腔静脉转移患者预后的重要因素,癌栓水平对肾癌患者的预后无明显影响,无远处转移者仍应考虑行手术治疗.[Objective]To explore the treatment and prognosis of renal cell carcinoma（RCC） with vena cava tumor thrombi. [Methods] Among 48 cases of RCC with vena cava tumor thrombi, 37 cases underwent radical nephrectomy and thrombectomy, and 11 cases（22.9%） had distant metastasis. The tumor survival was estimated by Kaplan-Meier method and the difference among groups was analyzed by log-rank tests. Cox regression model was used to analyze the influential factors of the prognosis of the tumor. [Results] The total 5- year survival of RCC was 40. 7%. Tumor thrombus was located at renal vein in 6 patients（12.5%）, the infra diaphragmatic inferior vena eava in 29 patients（60.5 %） and the supradiaphragmatic inferior vena cava in 13 pa- tients（27%）. There was no significant difference in the 5-year survival of vein tumor thrombi. The 5-year survival with and without distant metastasis was 8% and 56%, and there was significant difference between them （ P〈0.01）. The 5-year survival of the patients of tumor thromhi without distant metastasis after nephrectomy and thrombectomy was 68.3%, and that of the patients of tumor thrombi without surgical treatment was 18%, and there was significant difference between them（ P〈0.01）. [Conclusion]The distant metastasis is the important factor influencing the prognosis of the patients of RCC with vena cava tumor thrombi. The tumor thrombi have no obvious effect on the prognosis of RCC patients. The patients without distant metastasis should consider the surgical treatment.

关 键 词：肾肿瘤/治疗 肿瘤转移 预后 

分 类 号：R737.11[医药卫生—肿瘤]