摘要
目的 探讨老年局限性肾癌术后患者的临床特征及预后影响因素.方法 收集2004-2017年美国国立癌症研究所(SEER)数据库中所有接受过原发肿瘤切除手术的老年(60～100岁)局限性肾癌患者.分析患者的临床特征、手术方式和预后.根据手术方式分为肾部分切除术(PN)组和肾根治性切除术(RN)组,比较不同手术方式对预后的影响.结果 共纳入符合标准的20 348例患者.老年局限性肾癌患者术后的中位生存时间为164个月,3、5、10年累积总生存率依次为91.1％、84.2％、64.4％.多因素Cox分析显示,年龄、性别、种族、组织学分级、T分期、手术方式是影响术后总生存期的独立预后因素(P＜0.05).亚组生存分析结果显示,在所有老年年龄段、性别、种族、组织学分级、T1期肾癌方面,PN预后均优于RN(P＜0.05).对于T2期肾癌,PN和RN预后差异无统计学意义(P＞0.05).结论 确诊时年龄大、男性、黑种人、病理类型为非嫌色细胞癌、分化程度低、肿瘤T分期高、RN是影响老年局限性肾癌患者术后预后的独立危险因素.PN是老年局限性肾癌的主要治疗方式并具有显著的治疗效果.
Abstract
Objective To investigate the clinical features and prognostic factors of elderly patients with localized renal cell carcinoma after operation.Methods Clinical data of all elderly patients(60-100 years old)with localized renal cell carcinoma who underwent primary tumor resection during 2004 and 2017 in United States National Cancer Institute(SEER)database were collected.The clinical features,surgical methods and prognosis were analyzed.According to the surgical methods,the patients were divided into partial nephrectomy(PN)group and radical nephrectomy(RN)group.The effects of the two surgical methods on the prognosis were compared.Results A total of 20 348 patients were included.The median survival time was 164 months,and the 3-,5-and 10-year cumulative overall survival rates were 91.1％,84.2％and 64.4％,respectively.Multivariate Cox analysis showed that age,sex,race,histological grade,T stage and surgical method were independent prognostic factors for overall survival(P＜0.05).Subgroup survival analysis showed that the prognosis of PN was superior to that of RN in all age groups,gender,race,histological grade and T1 stage renal cell carcinoma(P＜0.05).For T2 stage renal cell carcinoma,there was no significant difference in the prognosis between patients who received PN or RN(P＞o.05).Conclusion Old age,male,black,non-chromophobe cell carcinoma,low degree of differentiation,high T stage of tumor and RN are independent risk factors for the prognosis of elderly patients with localized renal cell carcinoma.PN is the main treatment method and has remarkable therapeutic effects.
基金项目
解放军总医院"国家杰出青年科学基金"培育专项项目(2020-JQPY-002)
解放军总医院青年扶持基金(22QNFC096)
维普
万方数据