后腹腔镜肾部分切除术后切缘阳性与阴性的预后研究

摘要

目的 比较后腹腔镜下肾部分切除术后切缘阳性与阴性肾细胞癌患者的肿瘤学结果,探究切缘阳性对术后复发及生存率的影响. 方法 我院2008年至2013年期间对104例肾细胞癌患者行后腹腔镜下肾部分切除术,回顾性分析切缘阴性及阳性患者,对术后肿瘤相关死亡率、总体生存率及肿瘤复发率等进行比较. 结果 术后切缘阳性患者11例,切缘阴性患者93例.切缘阳性患者的术后肿瘤复发率(37·5%)较切缘阴性患者(5·4%)显著增高( P＜0·05 ) ,切缘阳性患者的肿瘤相关死亡率(0%)及总体生存率(90·9%)与切缘阴性患者(分别为3·2% 及87·1%)比较,差异无统计学意义(P＞0·05) . 结论 肾部分切除术后切缘阳性患者有较高的肿瘤复发率,但切缘阳性与阴性患者的肿瘤相关死亡率及总体生存率无统计学差异.%Objective To identify impact of positive or negative surgical margins on cancer re‐currence ,related death and overall survival rate in patients following retroperitoneal laparoscopic partial nephrectomy· Methods From 2008 to 2013 ,104 patients with renal cancer in our hospital treated with retroperitoneal laparoscopic partial nephrectomy were enrolled in our current study· Re‐currence rate ,cancer related death and survival rate were collected and analyzed· Results Postop‐erative margin was positive in 11 cases and negative in 93 cases· T he recurrence rate of positive mar‐gin patients (37·5%) was significantly higher than that of negative margin patients (5·4%)· Post‐operative mortality in patients with positive margins (0%) was not significantly different from that in patients with negative margins (3·2%)· T he overall survival rate of patients with positive margins (90·9%) was not significantly different from that of patients with negative margins (87·1%)· Conclusions Positive margin after partial nephrectomy is associated with high recurrence rate ,but there was no significant difference in mortality or overall survival rate between the two groups·