Practice patterns among urologic surgeons treating localized renal cell carcinoma in the laparoscopic age: Technology versus oncology
Practice patterns among urologic surgeons treating localized renal cell carcinoma in the laparoscopic age: Technology versus oncology
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DOI：
10.1016/s0090-4295(03)00773-8
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发表时间：
2003-12-01
期刊：
影响因子：
2.1
通讯作者：
del Pizzo, J
中科院分区：
文献类型：
--
作者：
Scherr, DS;Ng, C;del Pizzo, J
目标。评估腹腔镜检查对单个机构肾细胞癌治疗实践模式的影响。现在许多人将腹腔镜根治性肾切除术（LRN）视为治疗局限性肾细胞癌的标准治疗方法。随着腹腔镜检查在泌尿外科领域变得越来越普遍，实践模式正在发生变化。方法。我们分析了康奈尔大学威尔医学院1997年至2002年的肾癌手术数据库。我们比较了三组，包括开放性肾癌根治术（ORN）、开放性肾部分切除术（OPN）和LRN。结果。从 1997 年到 2002 年，总共进行了 222 例连续的肾脏手术，疑似患有恶性肿瘤。总共 194 例可评估。其中，63 个是 OPN，51 个是 ORN，80 个是 LRN。随着时间的推移进行分析，2000 年下半年，89% 的 LRN 是在尺寸小于 4 厘米的肿瘤上进行的。最近，在 2002 年，只有 42% 的 LRN 是针对尺寸为 4 厘米或更小的肿瘤进行的。从 1997 年到 2000 年，所有 OPN 中的 30% 是针对大于 4 厘米的肿瘤进行的，而 2000 年到 2002 年为 28%。在 1997 年到 2000 年期间进行的 30 例 OPN 中，有 21 例（70%）是针对小肿瘤（4 厘米或更小）进行的，而 2000 年至 2000 年期间，33 例中有 24 例（73%）是针对小肿瘤进行的。 2002.结论。从2000年到2002年，接受LRN治疗的小于4厘米肿瘤的百分比随着时间的推移而增加。在 ORN 队列中，对小肿瘤（小于 4 厘米）进行肾切除术的百分比随着时间的推移而下降，而 OPN 组的趋势保持相对稳定。随着机构对腹腔镜技术越来越熟悉，技术问题在泌尿科医师确定治疗算法方面可能发挥的作用越来越小。 (C) 2003 爱思唯尔公司。
Objectives. To evaluate the effect of laparoscopy on practice patterns at a single institution in the treatment of renal cell carcinoma. Many now regard laparoscopic radical nephrectomy (LRN) as a standard of care in the management of localized renal cell carcinoma. As laparoscopy becomes more prevalent in the urologic community, practice patterns are changing.Methods. We analyzed the renal cancer surgical database at the Weill Medical College of Cornell University from 1997 to 2002. We compared three groups, including open radical nephrectomy (ORN), open partial nephrectomy (OPN), and LRN.Results. A total of 222 consecutive renal surgeries done for presumed malignancy were performed from 1997 to 2002. A total of 194 were assessable. Of these, 63 were OPNs, 51 were ORNs, and 80 were LRNs. When analyzed over time, during the latter half of 2000, 89% of all LRNs were performed on tumors less than 4 cm in size. More recently, in 2002, only 42% of LRNs were performed for tumors 4 cm or less in size. From 1997 to 2000, 30% of all OPNs were done on tumors greater than 4 cm compared with 28% from 2000 to 2002. Of 30 OPNs performed from 1997 to 2000, 21 (70%) were performed on small (4 cm or less) tumors compared with 24 (73%) of 33 from 2000 to 2002.Conclusions. From 2000 to 2002, the percentage of tumors less than 4 cm that were treated with LRN has increased with time. In the ORN cohort, the percentage of nephrectomies performed on small tumors (less than 4 cm) has decreased with time, and the trends in the OPN group have remained relatively stable. As an institution becomes more comfortable with laparoscopic techniques, technological concerns are likely to play less of a role in determining treatment algorithms among treating urologists. (C) 2003 Elsevier Inc.