Treatment of osseous metastases in patients with renal cell carcinoma
Treatment of osseous metastases in patients with renal cell carcinoma
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DOI：
10.1097/01.blo.0000059580.08469.3e
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发表时间：
2003-04-01
影响因子：
4.2
通讯作者：
Scully, SP
中科院分区：
文献类型：
--
作者：
Jung, ST;Ghert, MA;Scully, SP
99例患者在一个机构治疗继发于肾细胞癌骨转移的记录进行了审查。患者随访至少24个月或直至死亡。从年龄、性别、无病期、骨转移部位、骨转移部位数量、骨转移切除和原发肿瘤切除等方面分析生存率。72名男性和27名女性的平均年龄为60岁（范围：34-82岁），平均随访时间为20个月（范围：2-81个月）。26例患者（26%）有孤立性骨转移，47例患者（48%）有多发性骨转移，26例患者（26%）在诊断时有其他内脏受累，如肺和脑。在49例患者（49%）中，肾细胞癌的诊断与骨转移的检测。存在一个骨转移的肾癌，广泛的切除病变，和肾切除术的历史被确定为独立的预测生存的肾细胞癌患者。8名患者广泛切除孤立性骨转移瘤并联合肾切除术，其疾病特异性生存率为100%（平均随访69个月，范围24-76个月）。具有这些特征的患者是具有治愈目的的积极手术治疗的候选者。
The records of 99 patients treated at one institution for osseous metastases secondary to renal cell carcinoma were reviewed. Patients were followed up for at least 24 months or until death. Survival was analyzed with respect to age, gender, disease-free interval, location of osseous metastases, number of osseous metastatic sites, resection of osseous metastases, and primary tumor resection. The mean age of the 72 men and 27 women was 60 years (range, 34-82 years) and the mean followup was 20 months (range, 2-81 months). Twenty-six patients (26%) had a solitary osseous metastasis, 47 patients (48%) had multiple osseous metastases, and 26 patients (26%) had additional visceral involvement such as the lung and brain at the time of diagnosis. In 49 patients (49%), the renal cell carcinoma was diagnosed concurrently with detection of the osseous metastasis. The presence of one osseous renal carcinoma metastasis, wide resection of the lesion, and a history of nephrectomy were identified as independent predictors of survival in patients with renal cell carcinoma. The eight patients who had wide resection of a solitary osseous metastasis in combination with a nephrectomy had a disease-specific survival rate of 100% (mean followup, 69 months; range, 24-76 months). Patients who present with these characteristics are candidates for aggressive surgical treatment with curative intent.