肾细胞癌剜除术远期疗效评价

目的:评价肾细胞癌剜除术的远期疗效.方法:回顾分析23例肾细胞癌患者行肿瘤剜除术的临床资料.结果:1例术中发现一侧肿瘤旁脂肪组织有癌细胞,当即作肾及周围脂肪囊切除;22例剜除术成功.其中,生存15年以上2例,10年以上3例,5年以上6例,2年以上11例.1例术后4年在其肾上极新生长一肿瘤;1例术后5年余,原剜除部肿瘤复发做了肾切除;其余20例皆良好.结论:临床I期CT或MRI肿瘤边缘清晰的肾细胞癌作单纯肿瘤剜除术治疗是可取的,但术中务必做周围组织活检.

Long-term effect of enucleation surgery for renal cell carcinomas(Report of 22 cases)

Purpose:To study the indication and long term results of encleation surgery for renal cell carcinomas (RCC).Methods:Twenty three cases of renal cell carcinomas (RCC) were reviewed in this retrospective analysis.Results:One of 23 cases was treated by radical nephrectomy immediately after enucleation of RCC because his perinephric fat was involved with tumor. The follow up periods of the other 22 cases with successful enucleation surgeries for RCC were as follows: more than 15 years in 2 cases, 10 years in 3 cases, 5 years in 6 cases, and 2 years in 11 cases. One case had a new tumor at the upper pole of ipsilateral kidney 4 years after the first surgery. Another patient developed local recurrence in the renal remnant after 5 years, and this patient received radical nephrectomy. The other 20 patients were in good condition during their follow up periods.Conclusions:Simple enucleation surgery was only indicated for RCC within stage I, and the tumor margin should have clear and distinct image shown by CT or MRI. Biopsy of the tissues adjacent to the neoplasms must be done during encleation surgery.