摘要
目的:总结孤立性肾上腺转移瘤的手术治疗经验。方法:总结22例原发肿瘤完整切除后发现并手术切除孤立性肾上腺转移瘤患者的临床资料,其中包括19例男性及3例女性患者。22例患者中9例接受腹腔镜下肾上腺切除术,余13例接受开放的肾上腺切除术。结果:被诊断为肾上腺同时转移的10例,异时转移的12例。平均的无疾病生存间期(DFI)为8个月。中位随访时间为33个月,22例患者的2年及5年总生存率分别为69%和18%,其中DFI等于或大于6个月的异时转移的患者其2年的总生存率(84%)高于DFI小于6个月的同时转移患者(50%)。对比腹腔镜手术及开放手术,腹腔镜肾上腺转移瘤切除并不会增加患者局部复发、切缘阳性的风险,对患者DFI及总生存率无影响。结论:治疗孤立性肾上腺转移瘤,尤其是对于DFI大于6个月的患者,手术切除后可以延长患者的总生存时间。手术方式上,腹腔镜下肾上腺转移切除时安全的、对患者有益的,可作为孤立性肾上腺转移瘤的首选方案。
Objective： To summarize the experience about the surgical treatment of the solitary adrenal metas- tasis. Methods： Twenty-two patients （male 19, female 3） received completeresection of the isolated adrenal me- tastasis after surgical treatment of primary tumor. The diagnosis of adrenal metastasis was synchronous in 10 patients and metachronous in 12 patients. The median disease-free interval was 8 months. In the 22 patients, 9 were per- formed with laparoscopic adrenaleetomy （LA） and the other 13 with open adrenaleetomy （OA）. Results： The o- verall 2-year survival and 5-year survival respectively was 69% and 18%. In the group of DFI greater than 6 months, the overall 2-year survival was 84% , compared with the 50% in the group of the DFI less than 6 months. Meantime compared with the two operation methods （LA and OA） , there was no significant difference in local re- currence, margin status, disease-free interval and overall survival. Conclusion： Surgical resection of the isolated adrenal metastasis, especially in the group of DFI greater than 6 months, could provide long-term survival in pa- tients previously received complete resection of the primary tumor. LA is safe and may be the initial approach for the solitary adrenal metastasis.
出处
《新医学》
2013年第5期332-335,共4页
Journal of New Medicine
关键词
肾上腺转移瘤
手术治疗
预后
生存时间
Solitary adrenal metastasis
Surgery
Prognosis
Survival time
