伴有静脉瘤栓的晚期肾细胞癌根治性切除术后的晚期生存和长期随访

IF 2 3区医学 Q3 ONCOLOGY

Journal of Surgical Oncology Pub Date : 2024-11-26 DOI:10.1002/jso.28020

Calvin L Chao, Nidhi K Reddy, Maxime Visa, Shilajit D Kundu, Mark K Eskandari

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引用次数: 0

摘要

背景和目的：本研究评估了接受根治性切除术和下腔静脉（IVC）血栓切除术的晚期肾细胞癌（RCC）患者静脉肿瘤血栓（VTT）的预后价值：方法：对接受RCC根治性肾切除术并伴有VTT的患者进行回顾性研究（2000-2024年）。将患者分为Neves 0-II组（肝下）和Neves III-IV组（肝上），对IVC受累情况进行单变量分析：共分析了64例患者（34例Neves 0-II组和30例Neves III-IV组）。患者或癌症特征无明显差异。内韦斯 III-IV 与失血量增加（> 2 L）（62.1% 对 37.9%，p = 0.02）、重症监护室住院时间延长（4.4 天对 1.4 天，p = 0.02）和术后住院时间延长（11.0 天对 6.5 天，p = 0.005）有关。总体而言，30天死亡率仅为1.6%，平均随访时间为56.1个月。局部复发率为 7.8%，IVC 通畅率为 96.9%。1年生存率为82.0%，5年生存率为58.4%，15年生存率为42.5%，Neves水平之间无显著差异：结论：根治性肾切除术配合 VTT 血栓切除术和原发性 IVC 修复术是安全的，早期生存率高，局部复发率低。IVC肿瘤血栓扩展的程度并不是影响早期或晚期生存的不良预后因素。

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Late Survival and Long-Term Follow-Up After Radical Resection of Advanced Renal Cell Carcinoma With Associated Venous Tumor Thrombus.

Background and objectives: This study evaluates the prognostic value of venous tumor thrombus (VTT) in patients with advanced renal cell carcinoma (RCC) undergoing radical resection and inferior vena cava (IVC) thrombectomy.

Methods: Retrospective review of patients with radical nephrectomy for RCC and associated VTT (2000-2024). Patients were dichotomized into Neves 0-II (infrahepatic) and Neves III-IV groups (suprahepatic) IVC involvement for univariate analysis.

Results: A total of 64 patients (34 Neves 0-II and 30 Neves III-IV) were analyzed. No significant differences in patient or cancer characteristics. Neves III-IV was associated with greater blood loss (> 2 L) (62.1% vs. 37.9%, p = 0.02), greater intensive care unit length of stay (LOS) (4.4 vs. 1.4 days, p = 0.02), and postoperative LOS (11.0 vs. 6.5 days, p = 0.005). Overall, 30-day mortality was only 1.6% with a mean follow-up of 56.1 months. Local recurrence was 7.8% and IVC patency 96.9%. One-year survival was 82.0%, 5-year survival was 58.4%, and 15-year survival was 42.5% without significant difference between Neves levels.

Conclusions: Radical nephrectomy with VTT thrombectomy and primary IVC repair is safe with high early survival and low local recurrence. Extent of IVC tumor thrombus extension is not a poor prognostic factor for early or late survival.

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来源期刊

Journal of Surgical Oncology 医学-外科

CiteScore

4.70

自引率

4.00%

发文量

367

审稿时长

2 months

期刊介绍： The Journal of Surgical Oncology offers peer-reviewed, original papers in the field of surgical oncology and broadly related surgical sciences, including reports on experimental and laboratory studies. As an international journal, the editors encourage participation from leading surgeons around the world. The JSO is the representative journal for the World Federation of Surgical Oncology Societies. Publishing 16 issues in 2 volumes each year, the journal accepts Research Articles, in-depth Reviews of timely interest, Letters to the Editor, and invited Editorials. Guest Editors from the JSO Editorial Board oversee multiple special Seminars issues each year. These Seminars include multifaceted Reviews on a particular topic or current issue in surgical oncology, which are invited from experts in the field.