腎細胞癌T3期亞群的存活率分析 – 單一機構回溯性研究
丁偉峰、邵翊紘、張英勛、虞凱傑、甘弘成、劉忠一、林柏宏、莊正鏗、馮思中
林口長庚紀念醫院 外科部 泌尿外科
Renal cell carcinoma T3 stages subgroup survival analysis - a retrospective single-institution study
Wei-Feng Ding, I-Hung Shao, Ying-Hsu Chang, Kai-Jie Yu, Hung-Cheng Kan, Chung-Yi Liu, Po-Hung Lin, Cheng-Keng Chuang, See-Tong Pang
Division of Urology, Department of Surgery, Chang Gung Memorial Hospital, Linkou
Purpose:
According to cancer registry data of Health Promotion Administration, Ministry of Health and Welfare in 2015, Kidney cancer is 15th most commonly diagnosed cancer in the male population and 18th ranking in the female population in Taiwan. In addition, the morality rate was 14th in male and 16th in female group. Consider to pathology classification, renal cell carcinoma is the most common cell type account for 95.81% male population and 90.13% female population. The purpose of this study is to analysis the survival rate of different renal cell carcinoma T3 stage subgroup in our hospital.
Materials and Methods:
We retrospectively reviewed the renal cell carcinoma T3 stage disease in our hospital from January 1999 to January 2019. In order to simplify the condition, N1 and M1 diseases were excluded. Total 86 patients were included and we divided them in 3 subgroups. Group A is tumor invasion to renal vein ; group B is tumor invasion to IVC(inferior vena cava) ; group C is tumor invasion to perirenal fat or renal sinus. Survival time (means and median) analysis is done for 3 groups. In addition, surgical time, blood loss, ICU admission and post-op admission days were compared between group A and group B.
Results:
Group A account for 28 cases(32.6%), group B account for 12 cases(14.0%) and group C account for 46 cases(53.5%). Age was from 62.1 ± 13.3 year-old. Male female ratio was 62 (72.1%) : 24 (27.9%). Median overall survival for A, B, and C is 84, 22, and 74 months and overall survival time was 69 months. We compared group A and B for surgical time, blood loss, ICU admission and post-op admission days. Mean surgical time was 227.54 : 426.58 mins in group A and B respectively(P<0.001). Mean blood loss was 650 : 2270 ml in group A and B(P=0.046). The mean of ICU stay was 0.07 : 2.0 in group A and B(P=0.005). Mean post-operation admission days was 7.11 : 17.50 days(P=0.129).
Conclusion:
Group B (Tumor invasion to IVC) had significantly lower overall survival comparing to group A (renal vein only) and group C (tumor invasion to perirenal fat or renal sinus). Median overall survival for A, B, and C was 84, 22, and 74 months respectively. Group B had significantly higher operation time, intraoperative blood loss, and ICU stay