Abstract：Objective: To investigate the influence of different surgical treatments on postoperative recurrence and metastasis and circulating tumor cell (CTC) in patients with stage T1b renal cell carcinoma (RCC). Methods: The case data of 88 patients with stage T1b RCC were retrospectively analyzed. According to different treatment methods, 42 patients undergoing partial nephrectomy were included in group A, and 46 patients receiving radical nephrectomy were enrolled as group B. The surgery-related indicators, renal function recovery conditions [estimated glomerular filtration rate (eGFR)], CTC level, postoperative recurrence and metastasis status [recurrence-free survival (RFS) rate within 3 years] and occurrence of postoperative complications were observed in the two groups. Results: There was no statistical difference in the intraoperative hemorrhagic fever time between groups (P>0.05). Compared with group B, group A had longer surgical time, less intraoperative estimated blood loss, and shorter postoperative hospital stay (P<0.05). eGFR level in group A at 1, 3 and 6 months after surgery had no statistical difference compared with that before surgery (P>0.05), eGFR level in group B at 1 month after surgery had no statistical difference compared to before surgery (P>0.05), and eGFR level at 3 and 6 months after surgery was decreased (P<0.05). The eGFR level in group A was not statistically different from group B at 1 month after surgery (P>0.05), and the eGFR level in group A was higher than that in group B at 3 and 6 months after surgery (P<0.05). The CTC count in both groups was increased at 7 days after surgery (P<0.05), but no statistical difference was shown in the CTC count at 3 months after surgery (P>0.05). The differences between the two groups were not statistical in terms of CTC count at various time points after surgery, RFS within 3 years and total incidence rate of postoperative complications (P>0.05). Conclusion: Both partial nephrectomy and radical nephrectomy are safe and effective in the treatment of patients with stage T1b RCC, with few postoperative complications. Both methods have the same effect on controlling tumor recurrence and metastasis. However, compared with radical nephrectomy, partial nephrectomy can better protect the renal function of patients and promote postoperative recovery.
任磊, 施量, 燕群峰, 叶明宝, 杜昌国, 王亚辉. 不同手术方式治疗T1b期肾癌对患者术后复发转移及CTC的影响[J]. 河北医学, 2025, 31(6): 923-928.
REN Lei, SHI Liang, YAN Qunfeng, et al. Effect of Different Surgical Modalities for T1b Stage Renal Cancer on Patients' Postoperative Recurrence Metastasis and CTC. HeBei Med, 2025, 31(6): 923-928.
[1] Harrison H,Thompson RE,Lin Z,et al.Risk prediction models for kidney cancer:a systematic review[J].Eur Urol Focus,2021,7(6):1380-1390. [2] Bahadoram S,Davoodi M,Hassanzadeh S,et al.Renal cell carcinoma:an overview of the epidemiology,diagnosis,and treatment[J].Ital Nefrol,2022,39(3):2022. [3] Teichgraeber DC,Guirguis MS,Whitman GJ.Breast cancer staging:updates in the AJCC cancer staging manual,8th edition,and current challenges for radiologists,from the AJ special series on cancer staging[J].AJR Am Roentgenol,2021,217(2):278-290. [4] 郭亚萍,石小玉.不同入路腹腔镜下肾部分切除术治疗早期肾癌患者的临床效果对比分析[J].实用癌症杂志,2022,37(1):105-107,110. [5] 毛天赐,张伟,罗娟.舒芬太尼静脉自控镇痛用于腹腔镜肾癌根治术镇痛效果及对患者炎症反应的影响[J].陕西医学杂志,2020,49(8):1016-1019. [6] 林博涵,邱钱仁顺,高睿承,等.机器人辅助肾部分切除术出血性并发症预测因素分析[J].现代泌尿生殖肿瘤杂志,2024,16(2):70-74. [7] 晏琦旻,阎倩,魏晓.腹腔镜肾部分切除术和肾癌根治术治疗T1b期肾癌患者的临床效果比较[J].国际泌尿系统杂志,2022,42(4):620-623. [8] 孙晓佳,汪业铭,孟晨雪,等.超声引导下腰方肌阻滞联合艾司氯胺酮在老年腹腔镜肾癌根治术患者中的应用效果[J].中国临床医生杂志,2023,51(10):1222-1225. [9] 赵宇豪,吕正钦,郭园园,等.腹腔镜肾癌根治术患者术后对侧肾脏慢性肾脏病发病的危险因素及其预测效能[J].山东医药,2023,63(30):58-61. [10] 舒帆,郝一昌,张展奕,等.肾部分切除术治疗囊性肾癌的功能学和肿瘤学结果:单中心回顾性研究[J].北京大学学报(医学版),2024,56(4):667-672. [11] Sawabata N,Susaki Y,Nakamura T,et al.Cluster circulating tumor cells in surgical cases of lung cancer[J].Gen Thorac Cardiovasc Surg,2020,68(9):975-983.
2025, Vol. 31 
冀公网安备13080202000786号