肾癌伴单发转移灶的治疗方法探讨

Exploring Management of Renal Cell Carcinoma with Solitary Metastasis

目的：探讨肾细胞癌伴单发转移灶病例的治疗方法。方法：回顾性分析1986～2003年肾癌伴单发转移和肾癌根治术后复发单个转移共51例病人的临床资料。除2例脑转移行放疗外,49例均行转移灶的外科切除辅以干扰素治疗。结果：17例肾癌根治及转移灶切除(1例放疗)治疗,总的平均生存期26．3个月。34例复发单个转移灶手术切除(1例放疗)后,总的平均生存期为41．9个月。肾癌根治切除术后复发转移间期在1年内的,转移灶切除后平均生存30．5个月,超过1年复发转移的为61．8个月(P＜0．05)。肝和脑转移灶术后疗效较其他部位的转移灶预后差。结论：时肾癌伴单发转移和根治术后复发单个转移应行肾癌及转移灶的外科切除,可延长生存期；1年以上复发转移间期的疗效较好。

Objective：To explore the effect of surgical excision for renal cell carcinoma with solitary metastasis. Methods：Between 1986-2003, fifty one patients with solitary metastasis to different sites from renal cell carcinoma or after radical nephrectomy for the primary lesion recurring solitary metastasis were analyzed. Except 2 brain metastasis treated with radiotherapy, other 49 cases underwent surgical excision with interferon more treatment used. Results： Patients had solitary metastasis at the time of presentation overall median survival was 26. 3 months. The survival of those who developed solitary metastases during follow-up after nephrectomy for primary was 41.9 months. The patients with longer one year interval between diagnosis and development of metastasis survived 61.8 months. The sites of metastasis in liver and brain had poor prognosis. Conclusion：Complete resection of either solitary metastasis at the time of presentation and primary lesions or solitary metastasis during follow up after nephrectomy from renal cell carcinoma may prolong survival term, The patients with longer one year interval between diagnosis and development of metastasis justified had longer survival after surgical treatment.