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在初始部分切除术失败后,救援部分切除术与激进切除术的比较分析
Jiwei Huang1, Ruopeng Su1, Cuijian Zhang2
1Department of Urology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Urologic oncology
|August 10, 2023
概括
挽救部分瘤切除术 (sPN) 提供了可比的瘤控制,可在初始部分瘤切除术失败后挽救激进瘤切除术 (sRN). sPN显著保持功能,使其成为需要重复脏手术的患者的首选选择.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 在瘤学瘤学.
- 手术创新 在外科创新.
背景情况:
- 部分切除术 (PN) 是小型质的标准,但复发需要抢救手术.
- 挽救选择包括挽救部分瘤切除术 (sPN) 和挽救激进瘤切除术 (sRN).
- 在初始PN失败后,存在有限的数据来比较sPN和sRN之间的瘤和功能结果.
研究的目的:
- 为了比较sPN和sRN之间的瘤结果和功能,在初始失败的PN之后.
- 评估救援瘤切除技术在治疗复发性瘤中的有效性和安全性.
主要方法:
- 回顾性多中心研究 (2008-2022) 分析了在初始PN失败后接受sPN或sRN的患者.
- 使用倾向性得分匹配 (PSM),平衡RENAL得分,瘤大小和病理T阶段.
- 通过考克斯模型和日志等级测试评估的瘤结局 (LRFS,RFS);使用威尔科克森等级总和测试评估的功能 (eGFR).
主要成果:
- 在sPN和sRN之间,在匹配前或之后,局部无复发生存率 (LRFS) 或无复发生存率 (RFS) 没有显著差异.
- 与sRN救助后手术相比,sPN表现出优异的功能维护,具有更高的eGFR和更少的eGFR损失 (P < 0.001).
结论:
- 挽救部分瘤切除术是挽救急性瘤切除术的可行替代方案,可在初始PN后复发.
- sPN提供可比的瘤控制,同时显著保持功能,使其成为首选的救援策略.
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