原发肾小细胞癌的临床特点及预后影响因素分析

Clinical characteristic and influencing factors of prognosis of primary small cell carcinoma of the kidney

目的探讨原发性肾小细胞癌(SCC)的临床特点和预后影响因素。方法收集国内外关于原发性肾SCC的病例报道,总结其临床特点和治疗方式,分析预后影响因素。结果共收集国内外50篇病例报道,总计87例患者。平均发病年龄为(54.7±17.1)岁,未发现明显的性别差异。手术是应用最多的治疗方式,化疗是一种重要的辅助治疗手段。中位生存期为15月,1年、2年及3年生存率分别为57.0%、32.0%及21.9%。单因素分析显示肿瘤临床分期是唯一影响预后的因素(P=0.008),尚未发现手术及化疗对预后有统计学意义的影响。结论原发性肾SCC是一种极其罕见并且恶性程度很高的肿瘤,尚缺乏标准有效的治疗方案。随着研究的不断深入,靶向治疗可能提供一种新的治疗方式但仍需更多的研究进一步证实。

Objective To investigate the clinical characteristics and factors affecting the prognosis of patients with primary small cell carcinoma （SCC） of the kidney.Methods Literatures on SCC of the kidney weresystemically searched to summarize the clinical features,treatment,and prognostic factors of this disease. Results A total of 50 reports involving 87 patients at home and abroad were collected. The patients average age was （54.7±17.1） years. No gender differences were found. Most patients received surgical treatment,with systemic chemotherapy as an adjuvant treatment. The median survival of patients was 15 months,and the 1,2 and 3year survival rates were 57.0%,32.0% and 21.9%,respectively. Univariate analysis indicated that pathological staging was the only significant prognostic factor（P=0.008）,and surgery and chemotherapy had no significant impact on the prognosis. Conclusion SCC arising in the kidney is an extremely rare and malignant neoplasm. The standard treatment regimen is still not determined. Targeted therapy may provide a new treatment.