肾单位保留术和肾癌根治术治疗T1b期肾癌的Meta分析  

Comparison of nephron-sparing surgery and radical nephrectomy for T1b renal cell carcinoma: a Meta-analysis

作　　者：苏静[1] 薛娇美 孙菲菲[1] 郭兆新[2] 程翔宇[2] 孟力维 刘照旭[2] 

机构地区：[1]山东大学护理学院,山东济南250012 [2]山东大学齐鲁医院泌尿外科,山东济南250012

出　　处：《山东大学学报（医学版）》2015年第9期65-70,79,共7页Journal of Shandong University:Health Sciences

摘　　要：目的比较肾单位保留术(NSS)和肾癌根治术(RN)治疗对侧肾功能正常的T1b期原发性肾癌患者预后结局。方法计算机检索Pub Med、Elsevier Science Direct、Web of Science、Co-chrane Library、中国期刊全文数据库(CNKI)、中国生物医学文献数据库、中文科技期刊数据库和万方数据库,查找所有比较NSS和RN治疗T1b期肾癌的队列研究,检索时限均为建库至2014年9月30日。同时手工检索纳入文献的参考文献。按纳入排除标准筛选文献、提取资料和评价质量后,采用Stata12.0软件进行Meta分析。结果共纳入11项研究,23 939例患者。M eta分析结果显示,NSS和RN治疗T1b期肾癌的5年[RR=1.05,95%CI(0.98,1.13)]、7年[RR=1.02,95%CI(0.94,1.10)]、10年[RR=1.30,95%CI(0.96,1.77)]的生存率差异无统计学意义;NSS的5年肿瘤特异生存率高于RN[RR=1.11,95%CI(1.06,1.16)];NSS的5年肿瘤特异死亡率低于RN[RR=0.70,95%CI(0.55,0.90)];NSS的肿瘤转移率低于RN[RR=0.38,95%CI(0.22,0.66)]。结论对于纳入本研究的患者,NSS和RN比较,患者的5、7、10年生存率相似,但NSS 5年肿瘤特异生存率高,5年肿瘤特异死亡率、转移率低。Objective To compare the outcomes of nephron-sparing surgery （NSS） and radical nephrectomy （RN） in treating TI b renal cell carcinoma （RCC）. Methods The following databases including Pubmed, Elsevier ScienceDirect, Web of Science, Co-chrane library, CNKI, CBM, VIP and WanFang were searched electronically from the date of their establishment to Sept. 2014 to collect cohort studies on NSS versus RN in the treatment of Tlb RCC, and the references of those studies were manually retrieved. After the studies were screened according to the inclusion and exclusion criteria, data were extracted and assessed, and Meta-analysis was performed using the Stata 12.0 software. Results A total of 11 studies with 23,939 patients were included. The results of Meta-analyses showed that, RN and NSS had no significant difference in 5-year [ RR = 1.05, 95 % CI（O. 98, 1.13 ） ], 7-year [ RR = 1.02, 95 % CI （0.94, 1.10） ], and 10-year [RR = 1.30, 95% CI （0.96, 1.77） ] overall survival （OS）. Nevertheless, NSS had higher 5- year cancer specific survival （CSS） [RR = 1. 11, 95% CI （ 1.06, 1. 16） ], lower 5-year cancer specific mortality （CSM） [ RR = 0.70, 95 % CI （0.55, 0.90） ] and lower metastasis rate [ RR = 0. 38, 95 % CI（0. 22, 0.66） ]. Conclu- sion For the patients who are included in the study, NSS and RN is comparable in 5-year OS, 7-year OS, 10-year OS ; NSS is superior to RN in 5-year CSS, 5-year CSM and metastasis rate.

关 键 词：肾单位保留术 肾癌根治术 T1b期肾癌 预后 META分析 

分 类 号：R737.11[医药卫生—肿瘤]