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目的总结根治性肾切除术治疗小肾癌的远期疗效。方法回顾性分析1992年1月至2004年6月采用根治性肾切除术治疗56例小肾癌患者的临床资料和长期随访结果。56例患者中男41例,女15例。平均年龄54岁。设计术后随访表进行追踪随访,采用Kaplan-Meier法计算5年、10年生存率。结果56例患者术前均未发现转移灶。术后组织病理学结果示肾透明细胞癌44例,颗粒细胞癌7例,混合性细胞癌5例；癌组织浸润同侧肾上腺1例,浸润肾周脂肪4例,局部淋巴结转移2例。术后49例(87.5%)获随访,随访时间11～155个月,平均随访71个月。5年、10年生存率分别为81.7%、66.9%。5例术后死于肾癌转移。结论根治性肾切除术治疗小肾癌的远期疗效较好,是治疗小肾癌较理想的术式。
Objective To summarize the long-term curative effect of radical nephrectomy on small renal cell carcinoma. Methods The clinical data and long-term follow-up results of 56 patients with small renal cell carcinoma treated by radical nephrectomy from January 1992 to June 2004 were retrospectively analyzed. 56 cases of male 41 cases, 15 females. Average age is 54 years old. Follow-up postoperative follow-up was designed and the 5-year and 10-year survival rates were calculated by Kaplan-Meier method. Results 56 patients had no metastases before surgery. Postoperative histopathological findings showed 44 cases of clear cell renal cell carcinoma, 7 cases of granulosa cell carcinoma and 5 cases of mixed cell carcinoma; 1 case of ipsilateral adrenal infiltration of cancerous tissue, 4 cases of perirenal fat infiltration and 2 cases of local lymph node metastasis. 49 cases (87.5%) were followed up for 11 to 155 months with an average follow-up of 71 months. Five years, 10-year survival rates were 81.7%, 66.9%. Five patients died of renal cell carcinoma metastasis. Conclusions Radical nephrectomy for the treatment of small renal cell carcinoma has good long-term curative effect and is an ideal surgical treatment for small renal cell carcinoma.