小儿肾母细胞瘤的治疗及生存分析

Treatment and survival analysis of nephroblastoma in children

目的总结小儿肾母细胞瘤的临床特点、治疗及预后,评价不同因素对其生存率的影响。方法回顾性分析2003年1月～2016年12月手术治疗的86例肾母细胞瘤的临床资料,采用Kaplan-Meier曲线进行生存率分析。结果 86例患儿中男59例,女27例,年龄0.7～5.8岁,平均(2.09±0.90)岁。术前化疗65例,直接手术21例,手术完整切除82例。随诊2～165月,中位随访时间53(2～165)月。死亡15例,1年、3年、5年的预期总生存率分别为91.6%、80.4%、80.4%。单因素预后分析显示病理分型及临床分期与生存率有关(P<0.01)。术前化疗患儿生存率高于未化疗患儿(P<0.05),3岁以下患儿生存率高于3岁以上患儿(P<0.05)。结论术前化疗及早期治疗能够有效改善预后,提高肾母细胞瘤患者的生存率。

Objective To investigate the clinical characteristics,treatment and prognosis of nephroblastoma in children.The influencing factors of survival were evaluated. Methods Clinical data of 86 children with nephroblastoma were collected,and the survival rate was analyzed with Kaplan-Meier curve. Results Of all 86 cases,59 were male and 27 were female,with an average age of （2.09±0.90）years （0.7-5.8）years.Sixty-five cases received preoperative chemotherapy.The nephroblastomas were completely resected in all 82 cases.During the follow-up of 2 to 165 months （median 53 months）,death occurred in 15 cases; the 1-,3-,and 5- year overall survival rates were 91.6 % ,80.4 % ,and 80.4 % ,respectively.Patients with different pathological types and clinical stages showed significant differences in the survival rate （ P 〈0.01）.Patients who received preoperative chemotherapy and patients who were 〈3-years had significantly higher survival rate （ P 〈0.05）. Conclusion Preoperative chemotherapy and early treatment are beneficial to the prognosis of children with nephroblastoma.