为细胞癌和瘤血栓进行激进切除术的患者的长期功能结果
Pietro Scilipoti1, Giuseppe Rosiello2, Alessandro Larcher1
1Department of Urology and Division of Experimental Oncology, URI, Urological Research Institute, IRCCS San Raffaele Scientific Institute, Via Olgettina, 60, 20132, Milan, Italy.
World journal of urology
|April 27, 2024
概括
细胞癌 (RCC) 与瘤血栓 (TT) 增加了手术后急性损伤和慢性病的风险. 尽管功能恶化,但TT患者长期保持稳定的功能.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
背景情况:
- 局部晚期细胞癌 (RCC) 可能涉及瘤血栓 (TT) 在高达15%的病例中.
- 根性切除术 (RN) 和血栓切除术是TT的RCC的标准治疗方法.
- TT对长期结果的影响需要进一步调查.
研究的目的:
- 评估瘤血栓 (TT) 对脏细胞癌 (RCC) 患者的长期功能和瘤结局的影响.
主要方法:
- 一个前性数据库确定了1207名因非转移性RCC而接受RN的患者 (2000-2021).
- 172名患者 (14%) 患有TT;分析评估了TT对术后急性损伤 (AKI) 和长期慢性病 (CKD) 的影响.
- 卡普兰-梅尔图和考克斯回归模型评估了无疾病生存率,癌症特异性生存率,临床进展率和癌症特异性死亡率.
主要成果:
- 与没有TT的患者相比,TT患者的BMI和手术前血红蛋白较低,但瘤大小较大.
- TT显著增加了术后AKI (OR 2.03) 和长期CKD (OR 1.32) 的风险.
- TT是临床进展 (HR 2.02) 和癌症特异性死亡率 (HR 1.61) 的预测指标,表明癌症结果更差.
结论:
- 瘤血栓 (TT) 是细胞癌 (RCC) 患者中不良的术后和长期功能的一个重要危险因素.
- 患有TT的患者在手术后的估计球过率 (eGFR) 显著早期下降.
- 尽管最初的功能下降,但TT患者的功能随着时间的推移保持稳定,保持可接受的水平.
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