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【文摘发布】肾细胞癌甲状腺转移手术治疗的临
Thyroid Metastases of Renal Cell Carcinoma: Clinical Course in 45 Patients Undergoing Surgery. Assessment of Factors Affecting Patients’ Survival
Igors Iesalnieks,1 Hauke Winter,2 Evelyne Bareck,3 Georgios C. Sotiropoulos,4 Peter E. Goretzki,5 Monika Klinkhammer-Schalke,6 Stefan Bro¨ckner,7 Arnold Trupka,8 Matthias Anthuber,9 Holger Rupprecht,10 Maximilian Raab,11 Willibald Meyer,12 Florian Reichmann,7 Manfred Ka¨ stel,13 Max Mayr,14 Wolfgang Braun,15 Hans J. Schlitt,1 and Ayman Agha1
Background: Metastases of renal cell carcinoma (RCC) to the thyroid gland are uncommon. There is no clear consensus regarding the role of surgery in metastatic disease to the thyroid since most clinical studies include small numbers of patients. Also, risk factors associated with disease progression following thyroidectomy are not yet defined. We examined the determinants of the outcome in patients undergoing surgery for thyroid metastases of RCC.
Methods: The medical records of 45 patients undergoing resection of thyroid metastases of RCC at 15 institutions in Germany and Austria were reviewed retrospectively. The outcome parameters assessed were overall survival and tumor-related survival. Factors associated with disease progression following thyroid surgery have been calculated.
Results: The overall 5-year survival rate following thyroid metastasectomy was 51%. Nineteen patients died during the study: 14 of disseminated disease and 5 of non-tumor-related causes. In the multivariate analysis, the prognosis was significantly worse in patients older than $70 years and in patients who had undergone nephrectomy
for metastases in the contralateral kidney during the course of the disease. Nine patients developed a thyroid recurrence following surgery. No local disease relapse occurred if resection margins were documented to be free of the tumor. Of the 45 patients with thyroid metastases, 14 (31%) developed pancreatic metastases during the course of disease. Ten of these patients also underwent pancreatic surgery with a 5-year survival rate of 43% in this subgroup.
Conclusions: The overall survival of patients undergoing thyroidectomy for metastases of RCC is affected rather by general health status than by tumor-related factors. There is a significant coincidence of thyroid and pancreatic metastases of RCC. 本人已认领该文编译，48小时后若未提交译文，请其他战友自由认领。 Thyroid Metastases of Renal Cell Carcinoma: Clinical Course in 45 Patients Undergoing Surgery. Assessment of Factors Affecting Patients’ Survival
肾细胞癌甲状腺转移手术治疗的临床病程和影响患者生存率的细胞因子评估
作者：Igors Iesalnieks,1 Hauke Winter,2 Evelyne Bareck,3 Georgios C. Sotiropoulos,4 Peter E. Goretzki,5 Monika Klinkhammer-Schalke,6 Stefan Bro¨ckner,7 Arnold Trupka,8 Matthias Anthuber,9 Holger Rupprecht,10 Maximilian Raab,11 Willibald Meyer,12 Florian Reichmann,7 Manfred Ka¨ stel,13 Max Mayr,14 Wolfgang Braun,15 Hans J. Schlitt,1 and Ayman Agha1
Background: Metastases of renal cell carcinoma (RCC) to the thyroid gland are uncommon. There is no clear consensus regarding the role of surgery in metastatic disease to the thyroid since most clinical studies include small numbers of patients. Also, risk factors associated with disease progression following thyroidectomy are not yet defined. We examined the determinants of the outcome in patients undergoing surgery for thyroid metastases of RCC.
背景：肾细胞癌发生甲状腺转移并不常见。甲状腺转移癌的手术治疗效果还没有达成清楚的共识，因为许多临床研究都只有比较少的病例数。而且，甲状腺切除术后与肿瘤进展相关的危险因素迄今为止并不确定。我们检测了决定肾细胞癌甲状腺转移手术患者预后的相关因素。
Methods: The medical records of 45 patients undergoing resection of thyroid metastases of RCC at 15 institutions in Germany and Austria were reviewed retrospectively. The outcome parameters assessed were overall survival and tumor-related survival. Factors associated with disease progression following thyroid surgery have been calculated.
方法：回顾性分析了德国和澳大利亚15个研究所的45例肾细胞癌甲状腺手术患者的临床资料。预后参数评估包括总生存率和肿瘤相关生产率。统计甲状腺切除术后与肿瘤进展相关的危险因素。
Results: The overall 5-year survival rate following thyroid metastasectomy was 51%. Nineteen patients died during the study: 14 of disseminated disease and 5 of non-tumor-related causes. In the multivariate analysis, the prognosis was significantly worse in patients older than $70 years and in patients who had undergone nephrectomy for metastases in the contralateral kidney during the course of the disease. Nine patients developed a thyroid recurrence following surgery. No local disease relapse occurred if resection margins were documented to be free of the tumor. Of the 45 patients with thyroid metastases, 14 (31%) developed pancreatic metastases during the course of disease. Ten of these patients also underwent pancreatic surgery with a 5-year survival rate of 43% in this subgroup.
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作者:admin@医学,生命科学 2011-09-09 05:15
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