Probability of Downsizing Primary Tumors of Renal Cell Carcinoma by Targeted Therapies Is Related to Size at Presentation
Probability of Downsizing Primary Tumors of Renal Cell Carcinoma by Targeted Therapies Is Related to Size at Presentation
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DOI：
10.1016/j.urology.2012.09.014
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发表时间：
2013-01-01
期刊：
影响因子：
2.1
通讯作者：
Bex, Axel
中科院分区：
文献类型：
--
作者：
Kroon, Bin K.;de Bruijn, Roderick;Bex, Axel
目的评价原发性肾肿瘤靶向治疗缩小肿瘤体积的可能性。方法通过文献检索，收集酪氨酸激酶抑制剂（tyrosine kinase inhibitors，TKIs）治疗原发性肾肿瘤的回顾性和前瞻性研究资料，并对治疗前后肿瘤体积进行分析。包括89例原发性肾透明细胞肿瘤，其中34例来自我们的研究所。获得治疗前后原发性肿瘤的最长直径。就诊时原发性肿瘤大小分为4类：10 cm（n = 27）。结果TKI为索拉非尼21例，舒尼替尼68例。较小的肿瘤大小与更有效的缩小有关（P = 0.01）。第一组（10 cm）的中位缩小率为32%（-46%至11%）。结论原发肿瘤越小，缩小的可能性越大，缩小越有效。新辅助治疗缩小原发肿瘤的消融技术或保留肾单位的手术可能存在潜在的好处，特别是在肿瘤大小为5至7厘米。泌尿学81：111 - 115，2013年。(c)2013 Elsevier Inc.
OBJECTIVE To evaluate the probability of downsizing primary renal tumors by targeted therapy in correlation to size.METHODS A literature search was conducted and our own data were pooled with data of retrospective series and prospective trials in which patients were treated with tyrosine kinase inhibitors (TKIs) and in which tumor sizes before and after treatment were reported. Included were 89 primary clear cell renal tumors, including 34 from our institutes. The longest diameter of the primary tumors before and after treatment was obtained. Primary tumor size at presentation was divided in 4 categories: 10 cm (n = 27). Pearson correlation and t test were used for statistical analysis.RESULTS The TKI was sorafenib in 21 tumors and sunitinib in the remaining 68. Smaller tumor size was related to more effective downsizing (P = 0.01). Median downsizing was 32% (-46% to 11%) in the first group (10 cm.CONCLUSION The smaller the primary tumor, the greater the likelihood and the more effective the downsizing. A potential benefit of neoadjuvant treatment to downsize the primary tumor for ablative techniques or nephron-sparing surgery may exist, particularly in tumors sized 5 to 7 cm. UROLOGY 81: 111-115, 2013. (c) 2013 Elsevier Inc.