摘要
目的总结报道中山大学肿瘤防治中心肾癌患者根治性肾切除术后的远期生存情况。方法收集1999—2020年在中山大学肿瘤防治中心接受根治性肾切除术的1367例无远处转移肾癌患者的临床病理和随访资料,以总生存为主要研究终点,采用Kaplan-Meier法进行生存分析,组间生存率的比较采用Log rank检验。肾癌患者根治性肾切除术后总生存的影响因素分析采用单因素和多因素Cox比例风险模型回归分析。结果中位随访52.6个月,1367例患者中死亡267例,存活1100例,中位总生存时间尚未达到,5年和10年总生存率分别为82.8%和74.9%。Leibovich评分低危组、中危组和高危组患者的5年总生存率分别为93.3%、82.2%和50.5%,10年总生存率分别为88.2%、72.3%和30.2%,3组远期生存差异有统计学意义(P<0.001)。pT1期、pT2期、pT3期和pT4期肾癌患者的10年总生存率分别为83.2%、73.6%、55.0%和31.4%,差异有统计学意义(P<0.001)。有淋巴结转移患者的5年和10年总生存率分别为48.5%和35.6%,无淋巴结转移患者的5年和10年总生存率分别为85.1%和77.5%,差异有统计学意义(P<0.001)。核分级G1级、G2级、G3级和G4级患者的10年总生存率分别为96.2%、81.6%、60.5%和43.4%,差异有统计学意义(P<0.001)。局限性肾癌(pT1~2N0M0)患者接受开放手术和微创手术后的10年总生存率分别为80.5%和85.6%,差异无统计学意义(P=0.160)。多因素Cox回归分析显示,性别、年龄、体质指数(BMI)、T分期、N分期、病理核分级、肿瘤坏死、肉瘤样分化是肾癌患者根治性肾切除术后总生存的独立影响因素,男性(HR=1.55,95%CI:1.04~2.31)、年龄≥55岁(HR=2.11,95%CI:1.50~2.96)、高T分期(T3~4期比T1a期:HR=2.37,95%CI:1.26~4.46)、N1期(HR=3.04,95%CI:1.81~5.09)、高病理核分级(G3~4比G1:HR=4.21,95%CI:1.51~11.75)、有肿瘤坏死(HR=1.66,95%CI:1.17~2.37)和有肉瘤样分化(HR=2.39,95%CI:1.31~4.36)的肾癌患者根治性肾切除术后总生存较�
Objective To report the long-term survival of renal cell carcinoma(RCC)patients treated with radical nephrectomy in Sun Yat-sen University Cancer Center.Methods We retrospectively analyzed the clinical,pathological and follow-up records of 1367 non-metastatic RCC patients treated with radical nephrectomy from 1999 to 2020 in this center.The primary endpoint of this study was overall survival rate.Survival curves were estimated using the Kaplan-Meier method,and group differences were compared through Log-rank test.Univariate and multivariate Cox analysis were fit to determine the clinical and pathological features associated with overall survival rate.Results A total of 1367 patients treated with radical nephrectomy with complete follow-up data were included in the study.The median follow-up time was 52.6 months,and 1100 patients survived and 267 died,with the median time to overall survival not yet reached.The 5-year and 10-year overall survival rates were 82.8%and 74.9%,respectively.The 5-year and 10-year overall survival rates of Leibovich low-risk patients were 93.3%and 88.2%,respectively;of Leibovich intermediate-risk patients were 82.2%and 72.3%,respectively;and of Leibovich high-risk patients were 50.5%and 30.2%,respectively.There were significant differences in the long-term survival among the three groups(P<0.001).The 10-year overall survival rates for patients with pT1,pT2,pT3 and pT4 RCC were 83.2%,73.6%,55.0%and 31.4%,respectively.There were significant differences among pT1,pT2,pT3 and pT4 patients(P<0.001).The 5-year and 10-year overall survival rates of patients with lymph node metastasis were 48.5%and 35.6%,respectively,and those of patients without lymph node metastasis were 85.1%and 77.5%,respectively.There was significant difference in the long-term survival between patients with lymph node metastasis and without lymph node metastasis.The 10-year overall survival rate was 96.2%for nuclear Grade 1,81.6%for nuclear Grade 2,60.5%for nuclear Grade 3,and 43.4%for nuclear Grade 4 patients.The differen
作者
邹湘鹏
宁康
张志凌
邹玲
熊龙滨
彭毓璐
周朝晖
刘辉明
俞春萍
董培
郭胜杰
韩辉
周芳坚
Zou Xiangpeng;Ning Kang;Zhang Zhiling;Zou Ling;Xiong Longbin;Peng Yulu;Zhou Zhaohui;Liu Huiming;Yu Chunping;Dong Pei;Guo Shengjie;Han Hui;Zhou Fangjian(Department 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;Department of Imaging,State Key Laboratory of Oncology in South China,Collaborative Innovation Center for Cancer Medicine,Sun Yat-sen University Cancer Center,Guangzhou 510060,China)
出处
《中华肿瘤杂志》
CAS
CSCD
北大核心
2023年第11期981-987,共7页
Chinese Journal of Oncology
基金
广东省自然科学基金杰出青年项目(2021B1515020077)。
关键词
肾肿瘤
根治性肾切除
生存分析
Renal neoplasms
Radical nephrectomy
Survival analysis
