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有些肾癌病人瘤栓经肾静脉进入腔静脉,若无淋巴结浸润或远外转移,仍有手术治疗可能。但肾癌瘤栓经常侵入腔静脉壁,其意义及腔静脉切除的作用尚不清楚。作者对一组已有腔静脉侵犯,并经受手术治疗的44例肾癌病人进行研究。瘤栓侵犯腔静脉占7.4%。27例原发瘤局限在吉氏筋膜内,无淋巴结浸润和远处转移(T3cN_0M_0期)。其中,接受了根治性肾切除,并以腔静脉摘除可动性瘤栓的病人,五年成活率69%(平均存活9.9年)。瘤栓侵入腔静脉壁者,五年成活率仅26%(平均存活1.2年),如果成功地切除受累的腔
Some renal cancer patients with tumor thrombus through the renal vein into the vena cava, if there is no lymph node infiltration or distant metastasis, there may still be surgical treatment. However, the tumor thrombi often invade the vena cava wall, and its significance and the role of vena cava resection is not yet clear. The authors studied a group of 44 patients with renal cancer who had an invaded vena cava and underwent surgery. Tumor invading vena cava accounts for 7.4%. Twenty-seven cases of primary tumors were confined to Gibson’s fascia, with no lymph node infiltration and distant metastasis (T3cN_0M_0 phase). Among them, patients who had undergone radical nephrectomy and removed vena cava with movable tumor embolus had a 5-year survival rate of 69% (average of 9.9 years). Tumor embolus invades the vena cava wall with a survival rate of only 26% in five years (average survival of 1.2 years) if the affected cavity is successfully resected