保留肾单位手术与肾癌根治术治疗T1期肾癌患者的生存预后比较  

Comparison of survival prognosis between nephron-sparing surgery and radical nephrectomy in patients with stage T1 renal cell carcinoma

作　　者：张灿峰 杨文博 刘嘉欣 ZHANG Can-feng;YANG Wen-bo;LIU Jia-xin(Xinxiang Central Hospital,Fourth Clinical College of Xinxiang Medical College,Xinxiang 453000,China)

机构地区：[1]新乡市中心医院,新乡医学院第四临床学院泌尿外科二病区,453000 [2]新乡市中心医院,新乡医学院第四临床学院重症医学科一区,453000

出　　处：《中国实用医药》2022年第24期57-61,共5页China Practical Medicine

摘　　要：目的比较T1期肾癌患者采用保留肾单位手术(NSS)与肾癌根治术(RN)治疗的生存预后情况。方法回顾性分析209例T1期肾癌患者的临床资料,依据手术方式不同分为NSS组(112例)与RN组(97例)。比较两组围手术期资料、术后10年总生存率、肿瘤特异性生存率、肿瘤无进展生存率、术后肾功能。结果RN组手术时间短于NSS组,差异有统计学意义(P<0.05)。NSS组3例患者分别在术后第1.2、4.9、7.6年去世;RN组14例患者在术后平均3.6年(0~8年,中位时间3.5年)去世。两组术后10年总生存率比较,差异有统计学意义[风险比(HR)=2.836,95%CI=(1.089,7.384),P=0.0328<0.05]。NSS组1例患者术后因肾癌去世;RN组11例患者在术后平均4年(0~8年,中位时间3.8年)因肾癌去世。两组肿瘤特异性生存率比较,差异有统计学意义[HR=4.041,95%CI=(1.2580,12.9700),P=0.0190<0.05]。NSS组2例患者术后因其他疾病去世;RN组3例患者术后因其他疾病去世。两组肿瘤无进展生存率比较,差异无统计学意义[HR=1.882,95%CI=(0.4123,8.5880),P=0.4144>0.05]。术后1、2年,两组平均肌酐值比较,差异无统计学意义(P=4.191、4.769>0.05)。术后3、4、5、6、7、8、9、10年,两组平均肌酐值比较,差异均有统计学意义(P=0.007、0.001、0.014、0.034、0.002、0.001、0.020、0.047<0.05)。结论T1期单侧肾癌患者采用NSS治疗的生存预后及术后肾功能均优于RN,当条件允许时,应首选NSS手术。Objective To compare the survival prognosis between nephron-sparing surgery(NSS)and radical nephrectomy(RN)in patients with stage T1 renal cell carcinoma.Methods The clinical data of 209 patients with stage T1 renal cell carcinoma were retrospectively analyzed and divided into NSS group(112 patients)and RN group(97 patients)according to different surgical methods.The perioperative data,10-year overall survival rate,tumor-specific survival rate,tumor progression-free survival rate,and postoperative renal function were compared between the two groups.Results The RN group had a shorter operation time than the NSS group,and the difference was statistically significant(P<0.05).3 patients in the NSS group died at 1.2,4.9,and 7.6 years after surgery,respectively;14 patients in the RN group died at an average of 3.6 years(0-8 years,median time 3.5 years)after surgery.There was a statistically significant difference in the 10-year overall survival rate between the two groups[hazard ratio(HR)=2.836;95%CI=(1.089,7.384);P=0.0328<0.05].1 patient in NSS group died of renal cell carcinoma after surgery;11 patients in the RN group died of renal cell carcinoma at an average of 4 years(0-8 years,median time 3.8 years)after surgery.There was a statistically significant difference in tumorspecific survival rates between the two groups[HR=4.041;95%CI=(1.2580,12.9700);P=0.0190<0.05].2 patients in the NSS group died of other diseases after surgery;3 patients in the RN group died of other diseases after surgery.There was no statistically significant difference in the tumor progression-free survival rate between the two groups[HR=1.882;95%CI=(0.4123,8.5880);P=0.4144>0.05].At 1 and 2 years after surgery,there was no statistically significant difference in the mean creatinine values between the two groups(P=4.191,4.769>0.05).At 3,4,5,6,7,8,9,and 10 years after surgery,the differences in the mean creatinine values between the two groups were statistically significant(P=0.007,0.001,0.014,0.034,0.002,0.001,0.020,0.047<0.05).Conclusion For pat

关 键 词：保留肾单位手术 肾癌根治术 生存预后 T1期单侧肾癌 

分 类 号：R737.11[医药卫生—肿瘤]