ROBUUST 2.0 レジストリの多施設分析

Francesco Ditonno¹, Alessandro Veccia¹, Gabriele Bignante²

¹Department of Urology, Azienda Ospedaliera Universitaria Integrata Verona, University of Verona, Verona, 37126, Italy.

World journal of urology

|September 2, 2025

まとめ

腎臓が単発した患者の上部管尿路がん (UTUC) の急性腎臓切除術 (RNU) はまれである. 結果は腎臓保存手術 (KSS) と比較され,手術前後の負担が大きいにもかかわらず,がん生存率が良好であった.

科学分野:

泌尿器科
腫瘍学
腎臓科

背景:

腎臓が1つしかない患者の上部経路泌尿器がん (UTUC) は,ユニークな臨床的課題です.
根性腎臓切除術 (RNU) と腎臓保存手術 (KSS) は治療の選択肢であり,それぞれが対側腎臓が欠けている患者に異なる影響を及ぼします.

研究の目的:

UTUCの単独腎臓患者のRNUとKSSの腫瘍学的および外科的アウトカムを比較する.
腎臓障害のUTUCに対する外科治療の可行性と効果を評価する.

主な方法:

UTUCの単発性腎臓患者のグローバル・マルチセンター・レジストリ (ROBUUST 2. 0) の遡及的分析
RNUとKSSのグループ間のベースラインの人口統計,疾患の特徴,および外科的特徴の比較.
カプラン- メイヤー生存分析 (RFS,MFS,CSS,OS) で,RNU患者の3年および5年の追跡調査を行った.

主要な成果:

39人の患者はRNU (76. 5%) と12人はKSS (23. 5%) を受けた.
RNU患者は,手術前の腎機能と合併症の割合が類似したにもかかわらず, signicantly longer median length of stay (LOS) を経験しました.
3年後に,RNU患者はOSの83. 9%,CSSの96. 9%,RFSの71. 8%,MFSの84. 4%を示し,5年後にそれぞれ73. 4%,83. 1%,59. 9%,78. 5%であった.

結論:

RNUまたはKSSを患っているUTUCの孤独な腎臓患者は,手術後の重要な課題に直面しています.
この研究は,単独の腎臓患者におけるUTUCの好ましい結末を示し,既存の文献と比較して,固有のリスクにもかかわらず,外科的介入を支持しています.

キーワード:

術後の合併症根性腎臓切除術腎不全腎不全単独の腎臓上部経路の泌尿器がん

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