摘要
目的探讨原发灶减瘤术(CN)对肾癌肺转移患者预后的影响。方法将美国国立癌症研究所监测、流行病学和结果(SEER)数据库中2010~2015年初诊肾癌肺转移患者,根据其是否实施CN分为减瘤组与未减瘤组。采用倾向性匹配(PSM)平衡两组基线资料的混杂因素,Kaplan-Meier法绘制生存曲线,采用Log-rank及COX比例风险模型,分析该手术对患者预后的影响。结果入组患者1898例,随访时间为1~82个月,中位随访时间13个月。PSM后,减瘤组中位OS为19个月,1、3年总生存(OS)率分别为63.12%、27.98%;未减瘤组中位OS为8个月,1、3年OS率分别为33.41%、9.41%。两组OS有显著差异(P<0.05)。COX多因素回归示,CN均为OS的独立保护因素。结论CN可显著改善肾癌肺转移患者预后。
Objective To explore the effects of cytoreductive nephrectomy(CN)on prognosis for renal cell carcinoma(RCC)patients with pulmonary metastasis.Methods The patients in the Surveillance,Epidemiology,and End Results(SEER)database of National Cancer Institute(NCI)who were preliminarily diagnosed with pulmonary metastasis of renal cell carcinoma from 2010 to2015 were divided into Group A(CN performed)and Group B(CN not performed)according to the presence of CN.Propensity score matching(PSM)was used to balance the confounders between the two groups,Kaplan-Meier was employed to draw the survival curve,and Log-rank test and Cox proportional-hazards models were used to analyze the effects of CN on the prognosis for patients.Results A total of 1898 patients were enrolled,with follow-up time of 1-82 months and median follow-up time of 13 months.After performing PSM,the median overall survival(OS)of Group A and Group B was 19 months and eight months,respectively;the 1-year OS and 3-year OS of Group A was 63.12%and 27.98%respectively,and the 1-year OS and 3-year OS of Group B was 33.41%and 9.41%respectively,showing significant difference(P<0.01).Cox multivariate regression analysis showed that CN was an independent protective factor of overall survival.Conclusion The cytoreductive nephrectomy can significantly improve the prognosis for RCC patients with pulmonary metastasis.
作者
何先东
韩博
吴舜
张克勤
He Xiandong;Han Bo;Wu Shun;Zhang Keqin(Department of Nephrology,the First Hospital,Army Medical University,Chongqing,400038,China)
出处
《西南国防医药》
CAS
2020年第2期96-99,共4页
Medical Journal of National Defending Forces in Southwest China
基金
解放军总后勤部保健专项科研课题(15BJZ28)
关键词
原发灶减瘤术
肾癌
肺转移
SEER
cytoreductive nephrectomy
renal cell carcinoma
pulmonary metastasis
SEER
