摘要
目的探讨外科治疗肾癌伴静脉癌栓患者的预后。方法自1994年8月至2004年7月共33例患者行肾癌根治术及静脉癌栓取出术，其中男性26例、女性7例，中位年龄60岁（20～82岁）。肾静脉癌栓15例，下腔静脉癌栓Ⅰ级（肝下水平）9例、Ⅱ级（肝后水平）5例、Ⅲ级（肝上水平）1例、Ⅳ级（右心房水平）3例。采用Kaplan—Meier方法进行生存分析。结果29例患者得到随访，14例死亡，平均生存（16．4±2．9）个月（1～42个月），15例存活，平均随访（17．3±4．6）个月（3～67个月）。1例患者术后第2天死亡，3例失访。5年生存率为16％。肾静脉癌栓患者平均生存（49．9±9．8）个月，明显高于Ⅰ级下腔静脉癌栓患者的（16．7±1．9）个月（P〈0．05）。结论肾癌根治性切除加癌栓取出术是治疗肾癌伴静脉癌栓的有效方法，肾静脉癌栓患者的预后好于腔静脉癌栓患者。
Objective To investigate the prognosis of surgical treatment for renal cell carcinoma with renal vein or inferior vena cava tumor thrombus. Methods Between August 1994 and July 2004, 33 patients with renal cell carcinoma with renal vein or inferior vena cava tumor thrombus underwent radical nephrectomy and thrombectomy. The study population included 26 male and 7 female. The median age was 60 years （20-82）. Level of tumor thrombus was renal vein in 15 patients, infrahepatic （ level Ⅰ） in 9, in trabepatic （level Ⅱ ） in 5, suprahepatic （ level Ⅲ ） in 1, and right atrial extension （ level Ⅳ ） in 3. Survival analysis was made with Kaplan-Meier method. Results Twenty-nine patients can be followed up. Fourteen patients were lost with a mean survival time of （ 16.4 ±2. 9） months （ 1-42 months）. Fifteen patients were survival with a mean follow-up of （ 17.3 ±4. 6） months （3-67 months）. One patient was lost on the second postoperative day. Three patients can not be followed up. The 5-year Kaplan-Meier survival rate was 16%. The mean survival time of patients with renal vein involvement [ （49.9 ± 9. 8 ） months] versus level Ⅰ [（16.7 ± 1.9） months] was significantly different （P 〈0.05）. Conclusions Radical nephrectomy plus thrombectomy is a valuable method for the treatment of renal cell carcinoma with renal vein or inferior vena cava involvement. Patients with renal vein tumor thrombus appear to have better survival compared to patients with inferior vena cava tumor thrombus.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2006年第10期678-680,共3页
Chinese Journal of Surgery
关键词
肿瘤循环细胞
肾切除术
肾癌
肾静脉癌栓
Carcinoma, renal cell
Neoplasm circulating cells
Nephrectomy
