在老年人群中患有静脉瘤的细胞癌的术后死亡率 (uroCCR研究第192号)
Norbert De Brek1, Charles Dariane2, Gaëlle Margue3
1Department of Urology, Hôpital Henri Mondor, AP-HP, 1 rue Gustave Eiffel, 94000, Créteil, France. norbert.debrek@aphp.fr.
World journal of urology
|October 11, 2025
概括
在70岁及以上的患者中,细胞癌 (RCC) 与下腔静脉 (IVC) 血栓的手术是可行的,但80岁及以上的患者面临更高的风险. 手术前的功能是这些患者90天死亡率的关键预测因素.
科学领域:
- 在瘤学瘤学.
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 外科手术的结果
背景情况:
- 下腔静脉 (IVC) 血栓是细胞癌 (RCC) 的严重并发症.
- 根性切除术与血栓切除术是标准治疗方法,但老年患者 (≥70岁) 的治疗结果尚未明确.
- 评估老年人手术的风险益处平衡至关重要.
研究的目的:
- 为了评估手术结果,专注于90天死亡率,在老年患者 (≥70岁) 具有RCC和IVC血栓.
- 在这个患者群体中确定与术后死亡率相关的风险因素.
- 为了确定是否仅仅是年龄就会对外科手术进行禁忌.
主要方法:
- 对来自法国UroCCR国家队列 (2007-2023) 的298名RCC和IVC血栓患者的回顾性分析.
- 患者被分为两类:≥70岁和<70岁.
- 主要终点是90天死亡率;次要结果包括整体生存率和疾病特异性生存率. 后勤回归被用于分析.
主要成果:
- 90天死亡率在70岁以上的患者中为10.5%,在70岁以下的患者中为5.5% (p=0.13).
- 在≥80岁的患者中,死亡率显著增加至19% (p=0.02).
- 转移性疾病和手术前功能障碍是90天死亡率的重要预测因素.
结论:
- 用血栓切除术进行彻底切除术,对于患有RCC和IVC血栓的70岁以上的患者提供了可接受的结果.
- 80岁以上的患者经历了较高的术后风险,需要仔细选择患者和术前评估.
- 疾病特异性存活率在各年龄组之间是可比的,这表明仅仅年龄不应该排除手术.
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