Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study
Renal cell carcinoma recurrences and metastases in primary non-metastatic patients: a population-based study
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DOI：
10.1007/s00345-016-1773-y
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发表时间：
2016-08-01
影响因子：
3.4
通讯作者：
Lundstam, Sven
中科院分区：
文献类型：
--
作者：
Dabestani, Saeed;Thorstenson, Andreas;Lundstam, Sven
为了介绍瑞典当代人群队列中原发性非转移性肾细胞癌（RCC）患者转移和局部复发的发生情况，在2005年至2009年期间，共有4527例患者被纳入瑞典国家肾癌前瞻性登记，占瑞典几乎所有RCC患者。在M0患者中，472例（13%）在5年随访时间内没有登记随访数据，因此被排除在分析之外。总计939例（21%）在就诊时有远处转移，在纳入期间从23%下降到18%。在3107例有随访数据的M0疾病患者中，623例（20%）在5年随访期间诊断为肿瘤复发。平均至复发时间为24个月（SD +/- A 20个月）。其中，570例（92%）患者在初步诊断时接受了根治性肾切除术，23例（3.7%）患者接受了肾部分切除术，12例（1.9%）患者接受了微创治疗。最常见的转移部位是肺（54%）、淋巴结（22%）和骨（20%）。50%的患者采用系统治疗，17%的患者行膀胱切除术，其中68%的患者有治愈意向。在这项基于人群的研究中，21%的患者在就诊时有转移性疾病，在研究期间呈下降趋势。在5年的随访中，20%的原发性非转移性患者有复发性疾病。在复发的患者中，一半接受了系统肿瘤学治疗，17%接受了膀胱切除术。
To present the occurrence of metastases and local recurrences in primary non-metastatic patients with renal cell carcinoma (RCC) in a contemporary Swedish population-based cohort.Between 2005 and 2009, a total of 4527 patients were included in the prospective National Swedish Kidney Cancer Register accounting for nearly all RCC patients in Sweden. Among M0 patients, 472 (13 %) had no follow-up data registered within 5-year follow-up time and were excluded from the analysis.In total, 939 (21 %) had distant metastases at presentation with a decrease from 23 to 18 % during the inclusion period. Of 3107 patients with follow-up data and with M0 disease, 623 (20 %) were diagnosed with a tumor recurrence during 5-year follow-up. Mean time to recurrence was 24 months (SD +/- A 20 months). Among these, 570 patients (92 %) were at primary diagnosis treated with radical nephrectomy, 23 patients (3.7 %) with partial nephrectomy and 12 patients (1.9 %) with minimally invasive treatments. The most frequent sites of metastases were lung (54 %), lymph nodes (22 %) and bone (20 %). The treatment of recurrence was in 50 % systemic treatments, while metastasectomy was performed in 17 % of the patients, out of which 68 % were with a curative intention.In this population-based study, 21 % of the patients had metastatic disease at presentation, with a decreasing trend over the study period. During 5-year follow-up, 20 % of the primary non-metastatic patients had recurrent disease. Of the patients with recurrence, half were given systemic oncological treatment and 17 % underwent metastasectomy.