分析细胞切除手术对少转移性肾细胞癌患者临床实践的影响

Q4 Medicine

Siberian journal of oncology Pub Date : 2024-03-22 DOI:10.21294/1814-4861-2024-23-1-53-62

D. V. Semenov, R. V. Orlova, V. I. Shirokorad, S. V. Kostritsky, M. Gluzman, Y. Korneva

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引用次数: 0

摘要

对少转移性肾细胞癌（RCC）患者进行囊肿肾切除术（CN）和转移灶切除术是合理的。目的：评估细胞切除手术对少转移性肾细胞癌患者生存率的影响。材料与方法。我们回顾性分析了2006年至2022年期间在莫斯科第62市立肿瘤医院和圣彼得堡市立肿瘤中心接受全身治疗和不同类型细胞剥脱手术的342例寡转移性RCC患者的数据。332名（97.1%）患者接受了细胞切除肾切除术，103名（30.1%）患者接受了转移切除术。通过生命表和卡普兰-梅耶曲线计算生存时间的描述性特征，使用生存分析法评估了治疗组患者的生存率。结果以 P<0.05 为有统计学意义。结果在单变量分析中，在接受 CN 治疗的患者中，对生存率预后有负面影响的因素包括肿瘤分级、骨转移证据、ALP、LdH 和 ESR 水平，以及 IMdC 模型和转移灶切除术的预后。在多变量分析中，只有 IMdC 预后对生存率有负面影响。在单变量和多变量分析中，在接受转移灶切除术的患者组中，只有IMdC预后对少转移性RCC患者的生存率有不利影响。结论我们的研究显示，CN和转移灶切除术对少转移RCC患者的OS有统计学意义的影响（P=0.02和P=0.032）。根据IMdC模型将患者分为不同的预后组，结果显示，CN并不能改善中等和不利预后的少转移RCC患者的OS率，而转移灶切除术能显著提高有利和不利预后的少转移RCC患者的OS率（P=0.0055和P=0.047）。在评估接受CN和转移灶切除术患者的预后因素时，只有IMdC预后对OS率有影响（p<0.001）。

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Analysis of the impact of cytoreductive surgery in patients with oligometastatic renal cell carcinoma in clinical practice

Cytoreductive nephrectomy (CN) and metastasectomy are justified in patients with oligometastatic renal cell carcinoma (RCC). Objective: to evaluate the impact of cytoreductive surgery on survival rates in patients with oligometastatic RCС. Material and Methods. We retrospectively analyzed the data of 342 patients with oligometastatic RCC, who underwent systemic therapy and different types of cytoreductive surgeries at the Municipal Oncology Hospital No. 62 in Moscow and the Municipal Oncoloy Center in Saint Petersburg from 2006 to 2022. Cytoreductive nephrectomy was performed in 332 (97.1 %) patients, metastasectomy in 103 (30.1 %) patients. The survival rates of patients in treatment groups were evaluated using the Survival Analysis by calculating descriptive characteristics of survival time by means of a life-table and Kaplan–Meier curves. The results were considered statistically significant at p<0.05. Results. In the univariate analysis, in patients who underwent CN, the factors that had a negative effect on the prognosis of survival rates were the tumor grade, evidence of bone metastases, levels of ALP, LdH, ESR, as well as prognosis according to the IMdC model and metastasectomy. In the multivariate analysis, only IMdC prognosis was found to have a negative effect on survival rates. In both the univariate and multivariate analysis, in the group of patients who underwent metastasectomy, IMdC prognosis alone had an unfavorable impact on survival rates of patients with oligometastatic RCC. Conclusion. Our study showed that CN and metastasectomy had a statistically significant effect on OS (p=0.02 and p=0.032) of patients with oligometastatic RCC. division of the patients into prognosis groups according to the IMdC model showed that CN did not improve the OS rates in patients with oligometastatic RCC with intermediate and unfavorable prognosis, and metastasectomy significantly increased the OS rates in oligometastatic RCC patients with favorable and unfavorable prognosis (p=0.0055 and p=0.047). When evaluating prognostic factors in patients undergoing CN and metastasectomy, only IMdC prognosis had an impact on the OS rates (p<0.001).

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来源期刊

Siberian journal of oncology Medicine-Oncology

CiteScore

0.40

自引率

0.00%

发文量

117

审稿时长

8 weeks

期刊介绍： The main objectives of the journal are: -to promote the establishment of Russia’s leading worldwide positions in the field of experimental and clinical oncology- to create the international discussion platform intended to cover all aspects of basic and clinical cancer research, including carcinogenesis, molecular biology, epidemiology, cancer prevention, diagnosis and multimodality treatment (surgery, chemotherapy, radiation therapy, hormone therapy), anesthetic management, medical and social rehabilitation, palliative care as well as the improvement of life quality of cancer patients- to encourage promising young scientists to be actively involved in cancer research programs- to provide a platform for researches and doctors all over the world to promote, share, and discuss various new issues and developments in cancer related problems. (to create a communication platform for the expansion of cooperation between Russian and foreign professional associations).- to provide the information about the latest worldwide achievements in different fields of oncology The most important tasks of the journal are: -to encourage scientists to publish their research results- to offer a forum for active discussion on topics of major interest - to invite the most prominent Russian and foreign authors to share their latest research findings with cancer research community- to promote the exchange of research information, clinical experience, current trends and the recent developments in the field of oncology as well as to review interesting cases encountered by colleagues all over the world- to expand the editorial board and reviewers with the involvement of well-known Russian and foreign experts- to provide open access to full text articles- to include the journal into the international database- to increase the journal’s impact factor- to promote the journal to the International and Russian markets