在患有同步转移性细胞癌,接受细胞还原性切除术和完整转移切除术的患者中,第一年复发的危险因素
Ali Ghasemzadeh1, E Jason Abel1, Jose A Karam2
1Department of Urology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
The Journal of urology
|August 5, 2025
概括
经过手术后实现无病状态的转移性细胞癌患者仍然可能面临复发. 早期复发,由肝转移,较大的瘤和高C反应蛋白预测,显著影响生存率.
科学领域:
- 泌尿病学和瘤学 泌尿病学和瘤学
- 手术瘤学手术瘤学
- 医学瘤学 医学瘤学
背景情况:
- 转移性细胞癌 (mRCC) 患有寡头转移性疾病的患者可以在细胞还原性瘤切除和转移切除后实现放射性完全缓解 (M1 NED).
- 识别患有复发高风险的患者对于优化术后管理至关重要.
研究的目的:
- 评估手术后获得M1 NED状态的mRCC患者的结果.
- 在这个队列中确定转移性复发和整体存活率的风险因素.
主要方法:
- 从四个机构 (2010-2020年) 获得M1 NED的109名mRCC患者的回顾性分析.
- 卡普兰-梅尔生存分析和后勤回归建模,以确定复发预测因素.
- 决策曲线分析,以评估预后模型的临床效用.
主要成果:
- 36名患者在第一年内出现了复发,而73名患者的复发延迟或没有复发.
- 一年复发与总体生存时间显著缩短有关 (15 vs 97 个月,P < .0001).
- 第一年复发的预测因素包括肝转移,较大的原发性瘤大小,以及手术前C反应性蛋白升高.
结论:
- 肝转移,原发性瘤大小和C-反应蛋白预测mRCC的细胞还原性手术后的早期复发.
- 达到M1 NED状态的高风险患者可能会受益于手术后立即的全身治疗,因为与早期复发相关的不良结果.
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