کد مقاله کد نشریه سال انتشار مقاله انگلیسی ترجمه فارسی نسخه تمام متن
3857700 1598871 2016 8 صفحه PDF سفارش دهید دانلود کنید
عنوان انگلیسی مقاله ISI
Treatment for T1a Renal Cancer Substratified by Size: “Less is More”
ترجمه فارسی عنوان
درمان T1A Substratified کلیوی سرطان با حجم: "کم هم زیاد است"
کلمات کلیدی
نئوپلاسم کلیه؛ تکنیک های فرسایش؛ سرطان بقا خاص؛ بقای قلبی و عروقی؛ سیستم عامل، بقای کلی؛ نفرکتومی جزئی؛ رادیکال نفرکتومی؛ سرطان کوچک کلیوی؛ فرسایش حرارتی
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
چکیده انگلیسی

PurposeDue to the widespread use of computerized tomography, the diagnosis of small renal cancers (3 cm or less) within the T1a classification continues to increase. Current treatment of these tumors includes radical nephrectomy, partial nephrectomy and thermal ablation. We used the SEER (Surveillance, Epidemiology, and End Results) Program to compare treatment modalities for these cancers based on 1 cm increments in tumor size. We examined overall survival, cancer specific survival, survival from cardiovascular disease and race based treatment disparities.Materials and MethodsIn the SEER database we identified 17,716 renal cancers 3 cm or less diagnosed from 2005 to 2010 treated with radical nephrectomy, partial nephrectomy or thermal ablation. Overall survival, cancer specific survival and cardiovascular survival were determined for each treatment group, and then substratified by size in centimeters, tumor grade, age, geographical location and ethnicity. Survival was analyzed using Kaplan-Meier methods, multivariate proportional hazards models and a propensity score weighted approach.ResultsOverall survival, cancer specific survival and cardiovascular survival were better for partial nephrectomy than radical nephrectomy in all circumstances. Thermal ablation showed equivalent overall survival to partial nephrectomy for tumors 2 cm or less. Notably, radical nephrectomy for renal tumors 3 cm or less was applied in a disparately larger number of black patients (OR 1.63, 95% CI 1.47–1.81) and Hispanic patients (OR 1.28, 95% CI 1.14–1.44).ConclusionsRadical nephrectomy should be avoided for all tumors 3 cm or less. For renal cancers 2 cm or less partial nephrectomy and thermal ablation are equally effective. For tumors 2.1 to 3 cm partial nephrectomy is better than thermal ablation. We identified significant racial treatment disparities that negatively impact survival in black and Hispanic patients.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 196, Issue 4, October 2016, Pages 1000–1007
نویسندگان
, , , , ,