对非转移性pT3a脏细胞癌的最小侵入性部分与激进切除术:一个多中心匹配的队列研究
Xiangpeng Zou1,2, Zhenhua Liu1,2, Yunhan Luo1,2
1Department of Urology, Sun Yat-sen University Cancer Center, Guangzhou, P. R. China.
概括
最少侵入性部分瘤切除术 (MIS-PN) 为pT3aN0M0细胞癌 (RCC) 提供了与激进瘤切除术 (MIS-RN) 相似的瘤结果. MIS-PN表现出优异的功能维护,使其成为选定的患者的可行选择.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 在瘤学瘤学.
- 腎臟病學 (nephrology) 是一種醫學專業.
背景情况:
- 微创手术越来越多地用于细胞癌 (RCC).
- 部分切除术 (PN) 旨在保护功能,而激进切除术 (RN) 涉及完全切除瘤.
- 评估瘤和功能结果对于pT3aN0M0 RCC的治疗决定至关重要.
研究的目的:
- 为了比较微创部分切除术 (MIS-PN) 与微创根性切除术 (MIS-RN) 的瘤和功能结果.
- 评估pT3aN0M0RCC患者的无复发生存期 (RFS) 和功能维护.
主要方法:
- 在303名pT3aN0M0 RCC患者的多中心回顾性研究中.
- 倾向分数匹配 (PSM) 和逆概率加权 (IPW) 用于平衡患者的特征.
- 卡普兰-梅尔生存分析和多变量分析 (MVA) 评估了瘤和功能结果,包括慢性脏病 (CKD-S).
主要成果:
- 在PSM后,MIS-PN和MIS-RN之间无复发性生存率 (RFS) 没有显著差异.
- MIS-RN独立地与术后发展慢性病 (CKD-S) 的更高风险有关.
- 在新的基线上,MIS-RN也被确定为更严重的CKD (CKD-S3b) 的风险因素.
结论:
- 对于pT3aN0M0 RCC,MIS-PN提供了与MIS-RN可比的瘤结果.
- 与MIS-RN相比,MIS-PN提供了优越的功能保护.
- 对于需要脏保护的 pT3a RCC 患者来说,MIS-PN 是一种可行的选择.
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