کد مقاله کد نشریه سال انتشار مقاله انگلیسی ترجمه فارسی نسخه تمام متن
3857693 1598871 2016 11 صفحه PDF سفارش دهید دانلود کنید
عنوان انگلیسی مقاله ISI
Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-Analysis
ترجمه فارسی عنوان
مدیریت توده های کلیوی و سرطان کلیه موضعی: مرور سیستماتیک و متاآنالیز
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کلمات کلیدی
سرطان، سلول کلیوی؛ تحقیقات مقایسه اثربخشی؛ مدیریت بیماری؛ نئوپلاسم کلیه؛ روش های جراحی، آژانس تحقیقات و کیفیت مراقبت های سلامت؛ سرطان بقا خاص؛ برآورد میزان فیلتراسیون گلومرولی؛
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
چکیده انگلیسی

PurposeSeveral options exist for management of clinically localized renal masses suspicious for cancer, including active surveillance, thermal ablation and radical or partial nephrectomy. We summarize evidence on effectiveness and comparative effectiveness of these treatment approaches for patients with a renal mass suspicious for localized renal cell carcinoma.Materials and MethodsWe searched MEDLINE®, Embase® and the Cochrane Central Register of Controlled Trials from January 1, 1997 through May 1, 2015. Paired investigators independently screened articles to identify controlled studies of management options or cohort studies of active surveillance, abstracted data sequentially and assessed risk of bias independently. Strength of evidence was graded by comparisons.ResultsThe search identified 107 studies (majority T1, no active surveillance or thermal ablation stratified outcomes of T2 tumors). Cancer specific survival was excellent among all management strategies (median 5-year survival 95%). Local recurrence-free survival was inferior for thermal ablation with 1 treatment but reached equivalence to other modalities after multiple treatments. Overall survival rates were similar among management strategies and varied with age and comorbidity. End-stage renal disease rates were low for all strategies (0.4% to 2.8%). Radical nephrectomy was associated with the largest decrease in estimated glomerular filtration rate and highest incidence of chronic kidney disease. Thermal ablation offered the most favorable perioperative outcomes. Partial nephrectomy showed the highest rates of urological complications but overall rates of minor/major complications were similar among interventions. Strength of evidence was moderate, low and insufficient for 11, 22 and 30 domains, respectively.ConclusionsComparative studies demonstrated similar cancer specific survival across management strategies, with some differences in renal functional outcomes, perioperative outcomes and postoperative harms that should be considered when choosing a management strategy.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 196, Issue 4, October 2016, Pages 989–999
نویسندگان
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