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Int J Urol:非转移性pT3a肾细胞癌的术后复发预测因素调查

2021-09-05 AlexYang MedSci原创

根治性肾切除和部分肾切除是非转移性RCC的根治性疗法。根治性手术患者的复发率约为30%,对于高风险复发患者需要进行密切随访。

根治性肾切除和部分肾切除是非转移性RCC的根治性疗法。根治性手术患者的复发率约为30%,对于高风险复发患者需要进行密切随访。

近期,来自日本的研究人员在《Int J Urol》发表文章,分析了肾外肿瘤扩展模式与其他病理因素,对非转移性pT3a肾细胞癌患者术后复发的影响

研究人员调查了2006年至2017年间,在日本大阪关西医科大学医院接受根治性手术的587名非转移性肾细胞癌患者。从中筛选了114名主要组织学类型为pT3a的患者亚群,其中包括93名透明细胞肾细胞癌患者(81.6%),13名未分类的肾细胞癌患者(11.4%),6名嗜铬细胞肾细胞癌患者(5.3%)和2名乳头状肾细胞癌患者。主要终点是无复发生存期。采用了Kaplan-Meier方法和Cox比例风险模型进行统计分析。

在114名pT3a肾细胞癌患者中,42名患者(36.8%)出现复发。多变量分析显示,肾周脂肪浸润(风险比2.36,P=0.009),肉瘤或横纹肌瘤(风险比2.88,P=0.022)以及坏死(风险比2.34,P=0.030)是无复发生存的独立预测因素。那些有两个以上独立预测因素的高风险pT3a患者预后不佳。高风险pT3a患者与pT3b或以上患者的无复发生存期相似(中位无复发生存期分别为23.0和10.8个月)。

pT3a患者的RFS分层

综上所述,pT3a肾细胞癌患者中,肾周脂肪浸润、肉瘤或横纹肌以及坏死,是预测无复发生存的独立因素有两个以上这些预测因素的患者预后较差。这些发现将有助于预测复发的风险分层,并为患者提供预后信息。

原始出处:

Haruyuki Ohsugi , Chisato Ohe , Takashi Yoshida et al. Predictors of postoperative recurrence in patients with non-metastatic pT3a renal cell carcinoma. Int J Urol. Aug 2021

 

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  5. [GetPortalCommentsPageByObjectIdResponse(id=1991847, encodeId=24c2199184ec9, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Fri Nov 26 05:21:56 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819697, encodeId=b492181969e26, content=<a href='/topic/show?id=b018996931d' target=_blank style='color:#2F92EE;'>#非转移#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99693, encryptionId=b018996931d, topicName=非转移)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Wed Jan 12 13:21:56 CST 2022, time=2022-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1979186, encodeId=8c7019e918677, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Wed Nov 03 01:21:56 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2080170, encodeId=5efb20801e07f, content=<a href='/topic/show?id=fc8c9969495' target=_blank style='color:#2F92EE;'>#非转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99694, encryptionId=fc8c9969495, topicName=非转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Dec 22 06:21:56 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264372, encodeId=524412643e243, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Tue Sep 07 07:21:56 CST 2021, time=2021-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386828, encodeId=459f13868283e, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Sep 07 07:21:56 CST 2021, time=2021-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014890, encodeId=6d151014890fc, content=关注了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=b3545492917, createdName=smart Ren, createdTime=Sun Sep 05 23:29:38 CST 2021, time=2021-09-05, status=1, ipAttribution=)]
  6. [GetPortalCommentsPageByObjectIdResponse(id=1991847, encodeId=24c2199184ec9, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Fri Nov 26 05:21:56 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819697, encodeId=b492181969e26, content=<a href='/topic/show?id=b018996931d' target=_blank style='color:#2F92EE;'>#非转移#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99693, encryptionId=b018996931d, topicName=非转移)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Wed Jan 12 13:21:56 CST 2022, time=2022-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1979186, encodeId=8c7019e918677, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Wed Nov 03 01:21:56 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2080170, encodeId=5efb20801e07f, content=<a href='/topic/show?id=fc8c9969495' target=_blank style='color:#2F92EE;'>#非转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99694, encryptionId=fc8c9969495, topicName=非转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Dec 22 06:21:56 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264372, encodeId=524412643e243, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Tue Sep 07 07:21:56 CST 2021, time=2021-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386828, encodeId=459f13868283e, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Sep 07 07:21:56 CST 2021, time=2021-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014890, encodeId=6d151014890fc, content=关注了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=b3545492917, createdName=smart Ren, createdTime=Sun Sep 05 23:29:38 CST 2021, time=2021-09-05, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1991847, encodeId=24c2199184ec9, content=<a href='/topic/show?id=ea25610484f' target=_blank style='color:#2F92EE;'>#术后复发#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=104, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=61048, encryptionId=ea25610484f, topicName=术后复发)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=62e4433, createdName=zz12341234, createdTime=Fri Nov 26 05:21:56 CST 2021, time=2021-11-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819697, encodeId=b492181969e26, content=<a href='/topic/show?id=b018996931d' target=_blank style='color:#2F92EE;'>#非转移#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99693, encryptionId=b018996931d, topicName=非转移)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Wed Jan 12 13:21:56 CST 2022, time=2022-01-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1979186, encodeId=8c7019e918677, content=<a href='/topic/show?id=3b90e79787f' target=_blank style='color:#2F92EE;'>#细胞癌#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=77978, encryptionId=3b90e79787f, topicName=细胞癌)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Wed Nov 03 01:21:56 CST 2021, time=2021-11-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2080170, encodeId=5efb20801e07f, content=<a href='/topic/show?id=fc8c9969495' target=_blank style='color:#2F92EE;'>#非转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99694, encryptionId=fc8c9969495, topicName=非转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Wed Dec 22 06:21:56 CST 2021, time=2021-12-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1264372, encodeId=524412643e243, content=<a href='/topic/show?id=daf1100226fb' target=_blank style='color:#2F92EE;'>#预测因素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=71, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100226, encryptionId=daf1100226fb, topicName=预测因素)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a57b78, createdName=朱睿睿, createdTime=Tue Sep 07 07:21:56 CST 2021, time=2021-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1386828, encodeId=459f13868283e, content=<a href='/topic/show?id=f08293399f9' target=_blank style='color:#2F92EE;'>#转移性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=93399, encryptionId=f08293399f9, topicName=转移性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1ac22500003, createdName=1249842em09(暂无昵称), createdTime=Tue Sep 07 07:21:56 CST 2021, time=2021-09-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1014890, encodeId=6d151014890fc, content=关注了, beContent=null, objectType=article, channel=null, level=null, likeNumber=107, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=b3545492917, createdName=smart Ren, createdTime=Sun Sep 05 23:29:38 CST 2021, time=2021-09-05, status=1, ipAttribution=)]
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