肾细胞癌引起的脊髓转移性损伤:肿瘤切除后的治疗和存活率

Q3 Medicine Hirurgia Pozvonochnika Pub Date : 2017-12-30 DOI:10.14531/SS2017.4.110-116
Н. С. Заборовский, С. В. Кострицкий, Дмитрий Пташников, В. И. Широкорад
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引用次数: 1

摘要

目标。目的探讨手术干预和靶向治疗对肾细胞癌脊柱转移患者治疗效果和生存的影响。材料和方法。对100例肾细胞癌脊柱转移患者进行回顾性分析,其中男性76例,女性24例,平均年龄58.4岁。39例患者行转移瘤切除术,61例患者行姑息性减压和稳定。26例患者接受了辅助靶向治疗(7例转移性切除,19例姑息性减压)。评估疼痛综合征(VAS)、神经状态(Frankel评分)和生存时间(从手术时刻到致命结局或最后一次随访检查)。Kaplan - Meier生存分析和Log-rank检验。p值< 0.05被认为是显著的。结果。所有患者均表现出神经功能的恢复和疼痛综合征的减轻。转移瘤切除术与姑息性减压患者的生存时间差异无统计学意义(p = 0.47)。接受靶向治疗的患者生存获益有统计学意义(p = 0.0019)。结论。靶向治疗增加肾细胞癌转移到脊柱患者的生存时间。转移瘤切除和额外的靶向治疗是可取的。
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МЕТАСТАТИЧЕСКОЕ ПОРАЖЕНИЕ ПОЗВОНОЧНИКА НА ФОНЕ ПОЧЕЧНО-КЛЕТОЧНОГО РАКА: РЕЗУЛЬТАТЫ ЛЕЧЕНИЯ И ВЫЖИВАЕМОСТЬ ПОСЛЕ УДАЛЕНИЯ ОПУХОЛИ
Objective. To evaluate the impact of surgical intervention and targeted therapy on the results of treatment and survival of patients with metastases of renal cell carcinoma to the spine. Material and Methods . Retrospective analysis of 100 patients (76 men, 24 women, mean age 58.4 years) with renal cell carcinoma metastases to the spine was carried out. Metastasectomy (en block resection) was performed in 39 patients, palliative decompression and stabilization — in 61. Twenty six patients received adjuvant targeted therapy (7 with metastasectomy, 19 with palliative decompression). The pain syndrome (VAS), neurological status (Frankel scale), and survival time (from the moment of surgery till the lethal outcome or the last follow-up examination) were assessed. The Kaplan – Meier survival analysis and Log-rank test were performed. A p-value < 0.05 was considered significant. Results . All patients demonstrated restoration of neurologic function and reduction of pain syndrome. There was no significant difference in survival time in patients with metastasectomy and palliative decompression (p = 0.47). Statistically significant survival benefit was observed in patients who underwent targeted therapy (p = 0.0019). Conclusion . Targeted therapy increases survival time in patients with renal cell carcinoma metastases to the spine. Metastasectomy is advisable with additional targeted therapy.
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来源期刊
Hirurgia Pozvonochnika
Hirurgia Pozvonochnika Medicine-Anesthesiology and Pain Medicine
CiteScore
0.60
自引率
0.00%
发文量
24
审稿时长
7 weeks
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