|本期目录/Table of Contents|

[1]程 尚,徐 勇,张志宏,等.pT1期肾透明细胞癌术后远期转移的影响因素分析[J].天津医科大学学报,2014,20(01):39-041.
 CHENG Shang,XU Yong,ZHANG Zhi-hong,et al.Independent factors for late recurrence of pT1 clear cell in patients with renal carcinoma after surgery[J].Journal of Tianjin Medical University,2014,20(01):39-041.
点击复制

pT1期肾透明细胞癌术后远期转移的影响因素分析(PDF)
分享到:

《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:
20卷
期数:
2014年01期
页码:
39-041
栏目:
临床医学
出版日期:
2014-01-20

文章信息/Info

Title:
Independent factors for late recurrence of pT1 clear cell in patients with renal carcinoma after surgery
文章编号:
1006-8147(2014)01-0039-03
作者:
程 尚徐 勇 张志宏姜行康齐士勇
(天津医科大学第二医院泌尿外科,天津市泌尿外科研究所,天津 300211)
Author(s):
CHENG ShangXU Yong ZHANG Zhi-hong JIANG Xing-kangQI Shi-yong
(Department of Urology ,The Second Hospital ,Tianjin Medical University ,Tianjin Institute of Urology ,Tianjin 300211 ,China)
关键词:
早期肾细胞癌远期转移多因素分析
Keywords:
pT1 renal cell carcinomalate recurrencemultivariate analysis
分类号:
R737.11
DOI:
-
文献标志码:
A
摘要:
目的: 探讨影响pT1期肾透明细胞癌患者术后远期转移的危险因素。 方法: 回顾性分析192例pT1期肾透明细胞癌术后5年未出现复发及远处转移患者临床资料。应用Kaplan-Meier单因素分析和COX多因素分析分别讨论性别、年龄、肿瘤部位、临床症状、手术方式、病理学分期、核分级、生物治疗等因素对pT1期肾细胞癌术后远期转移的影响。结果: 病理确诊为pT1期肾透明细胞癌的192例患者中,有15例发生了远期转移(7.8%),其中肺转移最常见(6例),中位随访期为8年(5~12年)。经Kaplan-Meier单因素分析及COX多因素分析结果显示:年龄≥50岁,伴有临床症状,病理学分期为pT1b期的患者较年龄<50岁(P=0.015),无临床症状(P=0.018)以及pT1a期(P=0.008)更易发生远期转移。结论: 远期转移为肾细胞癌的特殊生物学行为之一,特别是对于老龄、诊断时有临床症状和pT1b期肿瘤的患者,即使术后5年未出现转移证据,长期密切的随访仍非常必要。
Abstract:
Objective: To explore the independent prognosis factors in patients who had late recurrence of pT1 clear cell from renal cell carcinoma (RCC) after surgery. Methods: The study retrospectively reviewed 192 RCC patients after surgery and those who had not developed recurrence within 5 years of follow-up period from January 2001 to January 2008 in the institution. Clinical pathological factors such as Sex Age Tumor side Presentation Surgery Pathological stage Nuclear grade Treatment, were analyzed by the Kaplan-Meier univariate method and Cox multivariate analysis to find out their effects on the prognosis in PT1 RCC patients. Results: During a median follow-up period of 8 years (range 5~12 years), late recurrence was observed in 15 of the 192 (7.8%) patients, and pulmonary metastasis was the most common (6 patients). Univariate and multivariate analyses revealed that with clinical symptoms, patients whose age were more than 50 at pathologic T1b stage were more likely to suffer late recurrence. Conclusion: Late recurrence is one of the specific biologic behaviors of RCC. Careful long-term follow-up is necessary, especially in aged patients with clinical symptoms or pT1b tumors even if they have lived without disease for more than 5 years.

参考文献/References:

[1] Siegel R, Naishadham D, Jemal A. Cancer statistics,2012[J]. CA Cancer J Clin , 2012, 62(1) :10

[2] Chow W H, Devesa S S, Warren J L, et al. Rising incidence of renal cell cancer in the United States[J]. JAMA, 1999, 281(17):1628

[3] Kenny P A, Wood C G. Integration of surgery and asystemic therapy for renal cell carcinoma[J]. Urol Clin North Am, 2012, 39(2): 211

[4]Uchida K, Miyao N, Masumori N, et al. Recurrence of renal cell carcinoma more than 5 years after nephrectomy[J]. Int J Urol,2002,9(1):19

[5] 吴阶平. 泌尿外科[M]. 济南:山东科学技术出版社,1993:490-490

[6] Frank IBlute M LLeibovich B Cet alIndependent validation of the 2002 American Joint Committee on cancer primary tumor classification for renal cell carcinoma using alargesingle institution cohort[J].J Urol,2005,173(6):1889

[7]Sanchez-ortiz R F,Rosser CJ,Madsen L T, et al. Young age is an in dependent prognostic factor for survival of sporadic renal cell carcinoma [ J] . J Urol, 2004,171(6pt1):2160

[8] Leibovich B C , Blute M L ,Cheville J C , et al. Nephron sparingsurgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy[J ]. J Urol ,2004 ,171 (3) :1066

[9] Ljungberg B, Alamdari F I, Rasmuson T, et al. Follow-up guidelines for nonmetastatic renal cell carcinoma based on the occurrence of metastases after radical nephrectomy[J]. BJU Int, 1999, 84(4):405

[10] Stephenson A J, Chetner M P, Rourke K, et al. Guidelines for the surveillance of localized renal cell carcinoma based on the patterns of relapse after nephrectomy[J]. J Urol, 2004, 172(1):58

[11] Frank I, Blute M L, Cheville J C, et al. A multifactorial postoperative surveillance model for patients with surgically treated clear cell renal cell carcinoma[J]. J Urol, 2003, 170(6pt1):2225

[12] Park Y H, Baik K D, Lee Y J, et al. Late recurrence of renal cell caricinoma 5 years after surgery: clinicopathological characteristics and prognosis[J].BJU Int, 2012,110(11ptB):E553

[13] Miyao N, Naito S, Ozono S, et al. Late recurrence of renal cell carcinoma: retrospective and collaborative study of the Japanese Society of Renal Cancer[J]. Urology, 2011, 77(2):379

[14] Fourauier P,Regnard J F,Rea S,et al.Lung metastases of renal cell carcinoma:results of surigical resection[J].Eur J Cardiothorac Surg,1997,11(1):17

相似文献/References:

备注/Memo

备注/Memo:
作者简介 程尚(1986-),男,硕士在读,研究方向:泌尿系统肿瘤; 通信作者:徐勇,E-mail:xuyong8816@sina.com。
更新日期/Last Update: 2014-03-26