肾部分切除术治疗易位性肾细胞癌的疗效观察

Partial nephrectomy for the treatment of translocation renal cell carcinoma

目的:分析肾部分切除术治疗易位性肾细胞癌的数据,对治疗效果进行总结。方法:检索中国人民解放军总医院泌尿外科肾肿瘤数据库,选择2012年1月-2015年12月期间接受肾部分切除术治疗的、经病理确诊的易位性肾细胞癌病例资料。提取患者的临床病理及随访资料,并进行总结分析。结果:接受肾根治性切除术或肾部分切除术的3077例肾肿瘤患者中20例患者(0.6%)术后诊断为易位性肾细胞癌,其中7例患者(0.2%)接受肾部分切除术。7例患者中,男1例,女6例,中位年龄44(15~51)岁。左侧4例,右侧3例,临床肿瘤最大径1.3~5.6 cm,中位最大径2.8 cm。6例患者接受后腹腔镜肾部分切除术,1例患者接受机器人辅助腹腔镜肾部分切除术。中位手术时间120(66~170)min,中位估计出血量50(20~200)mL,中位热缺血时间26(20~34)min。病理结果显示均为切缘阴性,肿瘤未侵及肾周和肾窦脂肪,1例患者发生淋巴结转移。中位住院时间为15(9~19)d,所有患者中位随访42.0(31.6~61.5)个月,均无瘤生存。结论:肾部分切除术治疗较小的易位性肾细胞癌能获得满意疗效。

Objective:To investigate the outcomes of patients with translocation renal cell carcinoma(RCC)treated with partial nephrectomy.Methods:Our institutional review board-approved kidney cancer database was searched for patients who underwent partial nephrectomy between Jan.2012 and Dec.2015 for a pathologically con⁃firmed translocation RCC.We described the demographic,clinical,pathological,and follow-up data for this series of patients.Results:Between Jan.2012 and Dec.2015,3077 patients with RCC were treated at our institution with a partial or radical nephrectomy.In total,20(0.5%)patients were diagnosed as a translocation RCC,and 7(0.2%)of them underwent partial nephrectomy.Of these 7 patients,one was male,six were female,four had a left-side tumor,three had a right-side tumor.The median age was 44(15-51)years,and the median clinical tumor maximum diame⁃ter was 2.8(1.3-5.6)cm.Six patients received retroperitoneal laparoscopic partial nephrectomy,and one patient re⁃ceived robot-assisted laparoscopic partial nephrectomy.The median operative time was 120(66-170)min,the medi⁃an estimated blood loss was 50(20-200)mL,and the median warm ischemia time was 26(20-34)min.Pathological results showed that all patients achieved negative margin,no perirenal or sinus fat invasion was identified,and posi⁃tive lymph node was identified in one patient.The median hospital stay was 15(9-19)days.During a median followup of 42.0(31.6-61.5)months,all patients were alive without evidence of disease.Conclusions:According to our experience,partial nephrectomy for patients with small translocation RCCs can achieve satisfactory outcomes.