[对于cN0M0细胞癌的根性腎切除术中淋巴结解剖的预后值]
1Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
淋巴结解剖 (LND) 没有改善细胞癌 (RCC) 患者的存活率. 然而,LND对于准确的分期和指导辅助治疗决策至关重要.
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.
- 手术病理学手术病理学
背景情况:
- 激进切除术是局部细胞癌 (RCC) 的标准治疗方法.
- 淋巴结解剖 (LND) 在临床结节阴性 (cN0M0) RCC中的作用仍在争论中.
- 准确的分期对于预后和治疗计划至关重要.
研究的目的:
- 评估淋巴结解剖 (LND) 程度对cN0M0RCC患者长期生存的影响.
- 为了确定LND是否提供生存益处,与激进切除术后没有LND (NLND) 相比.
- 评估LND后淋巴结状况的预后值.
主要方法:
- 对1109名经过彻底切除术的RCC患者的回顾性分析.
- 对LND (n=512) 和NLND (n=597) 组进行比较,使用1:1的倾向分数匹配 (PSM).
- 考克斯比例危险模型用于评估整体存活率 (OS),癌症特异性存活率 (CSS) 和无进展存活率 (PFS).
主要成果:
- 在PSM后,在LND和NLND组之间没有观察到5年OS,CSS或PFS的显著差异 (P > 0.05).
- 多变量分析证实,在cN0M0 RCC中,LND与改善的OS,CSS或PFS无关.
- 在LND之后的病理性淋巴结阳性 (pN+) 是较差的OS,CSS和PFS的独立预测因素.
结论:
- 淋巴结解剖 (LND) 和其程度并不能改善cN0M0RCC患者的生存结果,这些患者接受了彻底切除术.
- LND对于准确的病态分期至关重要,有助于预后评估.
- 通过LND准确的分期对于指导辅助疗法的决定是有价值的.
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