【摘要】 目的:评价老年双肾肿瘤半保守治疗安全性。方法:对6例老年双肾肿瘤患者的临床资料进行回顾性分析。6例共12枚肿瘤,每例患者肿瘤均一大一小,影像学均高度怀疑肾癌。大肿瘤直径4.5~10.0cm,平均7.0cm均行根治性切除;小肿瘤直径1.8~2.7cm,平均2.3cm,予保守治疗。结果:手术均未发生严重的并发症,6例大肿瘤均为肾细胞癌:5枚混合细胞癌(以透明细胞为主型),分级Ⅱ级4枚、Ⅰ级1枚;1枚嫌色细胞癌,分级Ⅰ级。随访12~45个月,平均34个月,小肿瘤体积平均每年增大2.96(1.15~8.66)cm3,无局部浸润征象。手术侧未见复发,亦未见远处转移。结论:老年双肾肿瘤(一侧大肿瘤一侧小肿瘤)患者半保守治疗安全、有效。更多还原

【Abstract】 Objective:To evaluate the management of bilateral renal masses in elder patients.Methods:We reviewed the clinical data of 6 cases of patients with bilateral renal masses and received semi-conservative management from July 2000 to July 2004 in our hospital .Of these 6 patients, 4 were male and 2 were females. Average age was 71 years(range 65 to 80). Each patient had two solid masses: one big and one small. Six big masses had an average diameter at diagnosis of 7.0cm(range4.5 to 10.0) and were performed with RN. Six small masses had an average diameter of 2.3cm(range1.8 to 2.7) and were managed with watchful waiting. All patients were followed with computed tomography scans. Growth rate was calculated based on the tumor diameter and volume.Results:There were no serious surgical complications. Pathology revealed renal cell carcinoma in all 6(5 clear cell RCC and 1 chromophobe cell RCC). All were prospectively followed with CT for a median of 34 months (range 12 to 45). Mean tumor growth of the 6 small masses was 0.3 cm per year or 2.96 cm3, and there was no sign of local invasion. No recurrence was found in operative lateral and no evidence of metastasis.Conclusions:Conservative management is safe and effective for elder patients with bilateral renal masses(one big and one small).更多还原