【摘要】 目的比较肾部分切除术(PN)和根治性肾切除术(RN)在T1b肾细胞癌(RCC)治疗中的临床疗效,并为临床操作的选择提供循证医学证据。方法计算机检索CKNI数据库、万方数据库、维普数据库、Medline、Pubmed、Cochrane图书馆。检索时间:各数据库自建库至2016年12月01日。收集PN和RN在T1b期肾癌治疗中的研究文献,并使用Meta分析比较临床疗效。结果共纳入15篇研究文献,33262例肾癌患者,其中PN患者3756例,RN患者29506例,两种术式患者的5年及10年总生存率(OS)、5年及10年无复发生存率(RFS)、5年癌症特异性生存率(CSS)、局部复发率均无统计学差异(P>0.05);PN组10年CSS显著优于RN组(P<0.000 01)、PN组肿瘤远处转移发生率显著低于RN组(P=0.02)。结论与RN相比,在T1b期肾癌治疗中PN避免了不必要肾单位的破坏,减少相关并发症的发生,提高患者的生活质量。因此,PN是一种安全有效的手术方法。更多还原

【Abstract】 Objective To compare the clinical efficacy of partial nephrectomy(PN)and radical nephrectomy(RN)in the treatment of T1b renal cell carcinoma(RCC),and to provide evidence-based medicine for the choice of clinical operation.Methods The databases including CNKI,Wanfang,VIP,Medline,Pubmed as well as Cochrane Library were searched electronically.Search time was from created date of the database to December 1 st,2016.The literatures of PN or RN in the treatment of stage T1b RCC were collected and the clinical efficacy was compared using Meta analysis.Results 16 literatures including 34357 RCC patients were enrolled,4014 cases were in PN group and 30343 cases were in RN group,respectively.5-year and 10-year overall survival rate(OS),5-year and 10-year recurrence-free survival rate(RFS),5-year cancer-specific survival rate(CSS)as well as local recurrence rate was not statistically different between the two groups(P>0.05).The rate of 10-year CSS in PN group was significantly higher than that in PN group(P<0.000 01)and the rate of distant metastasis in PN group was significantly lower than that in RN group(P=0.02).Conclusion Compared with RN,treatment of PN for T1b stage RCC could retain more nephrons to reduce the incidence of complications and enhance the life quality of patients.Thus,PN is a safe and effective surgical approach.更多还原