保留肾单位手术与根治性肾切除术治疗局限性肾癌的临床疗效比较

发布时间：2018-03-23 17:57

  本文选题：局限性肾癌　切入点：保留肾单位手术　出处：《广西医科大学》2014年硕士论文

【摘要】：目的分析及比较保留肾单位手术(nephron sparing surgery, NSS)与根治性肾切除术(radical nephrectomy, RN)治疗局限性肾癌的临床疗效。 方法回顾性分析我科从2008年1月至2013年12月行NSS或RN治疗的180例患者的病例资料,患者的生存结局(转移、复发及死亡与否)通过查阅影像资料、病历和电话随访获得,最终137例肾癌患者获得随访(3.-.72个月,中位随访时间29个月),其中行NSS32例,RN为105例。对比分析两组共137例患者的年龄、性别、术前临床表现、肿瘤大小、术后TNM分期、并发症发生率,并用Kaplan-Meier法对两组的总生存率、肿瘤特异性生存率、无疾病进展生存率等作生存分析。 结果两组均顺利完成手术,对于51例≤4cm的肾癌患者,NSS组(n=27)的3年、5年的肿瘤特异性生存率均为100%；RN组(n=24)的3年、5年的肿瘤特异性生存率都为92.9%,两组整体比较无统计学差异(P=0.398)。而对于137例肾癌患者,两组的3年和5年的总生存率、肿瘤特异性生存率、无疾病进展生存率比较均无统计学差异(P0.05)。 结论对于临床分期为pTla甚至pT1b期的肾癌患者,NSS能最大限度保留肾单位,避免发生术后肾衰竭的可能,且控制肿瘤的远期疗效与RN相当,是一种安全、有效的术式。
[Abstract]:Objective to analyze and compare the clinical efficacy of nephron sparing Surgeryand radical nephrectomy in the treatment of localized renal cell carcinoma. Methods the data of 180 patients treated with NSS or RN from January 2008 to December 2013 were retrospectively analyzed. One hundred and thirty-seven patients with renal cell carcinoma were followed up for 3.-.72 months. The median follow-up time was 29 months. The age, sex, preoperative clinical manifestation, tumor size and postoperative TNM stage of 137 patients with renal carcinoma were compared and analyzed. The overall survival rate, tumor-specific survival rate and disease-free survival rate of the two groups were analyzed by Kaplan-Meier method. Results the operation was successfully completed in both groups. For 51 patients with renal cell carcinoma 鈮，

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