Stauffer综合征44例报告

Stauffcr＇s syndrome associated with renal cell carcinoma： report of 44 cases

目的报告伴Stauffer综合征的肾癌患者随访结果，探讨Stauffer综合征的临床意义。方法2000年至2006年，经手术病理证实的642例肾细胞癌患者中44例确诊为Stauffer综合征。男32例，女12例。年龄38～80岁，平均61岁。肾肿瘤直径3～13cm，平均8cm。AJCC分期：Ⅰ期18例、Ⅱ期18例、Ⅲ期4例、Ⅳ期4例。行根治性肾切除术34例，肾部分切除术6例，肾动脉栓塞术4例。结果40例获得术后病理的患者中透明细胞癌34例、乳头状细胞癌4例、嫌色细胞癌1例、集合管癌1例。治疗后1个月内肝功能恢复正常28例，1年内恢复正常10例，肝功能持续异常6例。44例随访5～80个月，平均63个月，3、5年生存率分别为65．9％（29／44）和45．5％（20／44）。肝功能持续异常者3、5年生存率分别为33．3％和0。结论伴Stauffer综合征的肾癌治疗应以手术切除为主，多数患者术后短期内肝功能恢复正常，肝功能持续异常者预后相对不良。伴Stauffer综合征的。肾癌患者连续检测肝功能对肿瘤复发和预后的判断有重要意义。

Objective To report the long-term follow-up results and to investigate the clinical features of Stauffer＇s syndrome associated with renal cell earcinoma（RCC）. Methods The data of 642 RCC patients from 2000 to 2006 were analyzed retrospectively and 44 patients with Stauffer＇s syndrome were selected. There were 32 males and 12 females with average age of 61（38--80）years. The average tumor size was 8 cm in diameter （3--13 cm）. AJCC staging showed 18 cases in stageⅠ, 18 cases in stageⅡ, 4 cases in stageⅢ and 4 cases in stage Ⅳ. Of the 44 cases, 34 underwent radical nephrectomy, 6 underwent partial ncphrectomy and 4 underwent renal artery embolization. Results The postoperative pathology consisted of clear cell carcinoma in 34 cases, papillary cell carcinoma in 4 cases, chromophobe cell carcinoma in 1 case and collecting duct cell carcinoma in 1 case. Hepatic function normalized in 28 cases one month after the operation and in 10 cases one year after the operation. Persistence of hepatic dysfunction was found in 6 cases. All cases were followed up for average 63 months （5--80 months）. 3-year and 5-year survival rate was 65.9 % （29/44） and 45.5 % （20/44）, respectively. 3-year and 5-year survival rate of patients with persistent hepatic dysfunction was 33.3% and 0. Conclusions Surgical resection is the fundamental option in the treatment of RCC accompanied with Stauffefs syndrome. Hepatic function will normalize in most cases after operation. Persistence of hepatic dysfunction is almost indicative of the presence of viable tumor and thus predicts a poor prognosis.