肾癌伴淋巴转移的治疗体会(附7例报告)  

The treatment of renal cell carcinoma associated with lymph node metastasis:report of 7 cases

作　　者：蔡晨[1] 董勤[2] 王林辉[3] 刘冰[3] 杨庆[3] 孙颖浩[3] 

机构地区：[1]第二军医大学长海医院特需诊疗科,上海200433 [2]上海市武警总医院肾内科 [3]第二军医大学长海医院泌尿外科,上海200433

出　　处：《现代泌尿生殖肿瘤杂志》2011年第1期19-21,共3页Journal of Contemporary Urologic and Reproductive Oncology

摘　　要：目的探讨肾癌伴淋巴转移患者的治疗体会。方法回顾分析我院2002年1月至2008年1月期间接受手术治疗的肾癌伴淋巴转移患者的治疗资料。结果共手术治疗肾癌伴淋巴转移病例7例,所有患者均行肾癌根治术并淋巴清扫。其中男性4例,女性3例,肿瘤直径(12.6±3.5)cm。7例患者中1例T2期,6例T3期,7例均无远处转移依据,所有患者均存在淋巴结侵犯,3例患者存在多处淋巴结转移,分别涉及肾门淋巴结(1例)、腹主动脉旁淋巴结(4例)、左髂动脉淋巴结(1例)、腔静脉旁淋巴结(3例)、肾上腺区淋巴结(1例),有1例患者存在下腔静脉及右肾静脉癌栓。6例术后予以干扰素等综合治疗。共随访10个月～8年,平均3.7年,截止2010年4月1日,患者生存率为42.86%。结论肾癌伴淋巴转移患者手术难度大,术前完善检查、术中行淋巴清扫、术后予以综合治疗对于提高手术成功率具有重要作用,且有可能延长患者的生存时间。Objective To discuss the treatment of patients with renal cell carcinoma associated with lymph node metastasis.Methods From January 2002 to January 2008,the clinical data of patients with surgically-treated renal cell carcinoma associated with lymph node metastasis were retrospectively analyzed.Results 7 patients（4 male and 3 female）with tumors＇ mean diameter of（12.6±3.5）cm were enrolled in this study.All patients underwent radical nephrorectomy and lymph node dissection.1 case was T2 stage and 6 cases were T3 stage.All patients presented no distant metastasis but lymph node involvement happened in all patients in which 1 patient presented renal hilar lymph node involvement,3 periaortic lymph node invasion,4 lymph node metastasis around left common artery,3 around inferior vena cava and 1 in adrenal region.1 patient presented tumor thrombus extension into inferior vena cava and right renal vein.6 of all patients underwent comprehensive therapy including interferon and were followed up with mean time of 3.7 years（range,10-96 months）.The survival rate was 42.86%.Conclusions The operation for patients with renal cell carcinoma associated with lymph node metastasis was difficult to perform,however,postoperative comprehensive therapy combined with careful preoperative examination and lymph node dissection can improve the achievement ratio of surgeries,and probably prolong the survival of these patients.

关 键 词：肾肿瘤 淋巴转移 综合疗法 

分 类 号：R737.11[医药卫生—肿瘤]