文章：

一项关于T1期肾细胞癌部分肾切除术后良性病理率全国性研究：我们是否应感到满意？

A National Study of the Rate of Benign Pathology After Partial Nephrectomy for T1 Renal Cell Carcinoma: Should We Be Satisfied?

原文发布日期：17 October 2024

DOI: 10.3390/cancers16203518

类型: Article

开放获取: 是

英文摘要：

Objectives: To determine the rate of benign pathology in cT1 tumors following partial nephrectomy in the Netherlands, thereby evaluating the rate of overtreatment.Methods:Data were collected from a nationwide database containing histopathology of resected renal tissue from 2014 to 2022. Patients who underwent partial nephrectomy for suspected RCC staged T1a-b were extracted for analysis. Data are shown in percentages, and multivariable logistic regression was performed to determine predictive factors for benign pathology.Results: 3409 cases were analyzed, of which 403 (12%) were benign and 3006 (88%) malignant. Subtype analysis showed 2126 (62%) cases of clear-cell RCC, followed by 604 (18%) of papillary RCC and 344 (10%) oncocytomas. Mean age was 63 years among patients with malignant pathology versus 65 years for patients with benign lesions (p< 0.001). Mean tumor size was 3.2 cm for malignant pathology and 2.9 cm for benign (p< 0.001). The rates of benign and malignant pathology did not change between 2014 and 2022 (p= 0.377). Multivariable regression showed age ≥ 65 years (65–79 years [OR 1.881,p= 0.002], ≥ 80 years [OR 3.642,p< 0.001]) and tumor size (OR 0.793,p< 0.001) as predictors for benign pathology. The main limitation of this study is that we do not know the biopsy rate of our cohort.Conclusion:This study reports a low rate of 12% benign pathology after partial nephrectomy in the Netherlands. It remains debatable whether these rates are acceptable, or if renal tumor biopsies should be utilized more frequently to reduce overtreatment.

摘要翻译： 

目的：通过分析荷兰cT1期肿瘤患者接受肾部分切除术后的良性病理检出率，评估当前临床实践中过度治疗的发生情况。 方法：研究数据来源于2014年至2022年全国肾脏切除组织病理学数据库。筛选因疑似T1a-b期肾细胞癌（RCC）接受肾部分切除术的患者进行分析。数据以百分比形式呈现，并采用多变量逻辑回归分析良性病理的预测因素。 结果：共纳入3409例病例，其中良性病变403例（12%），恶性病变3006例（88%）。亚型分析显示：透明细胞癌2126例（62%），乳头状肾细胞癌604例（18%），嗜酸细胞瘤344例（10%）。恶性病变患者平均年龄63岁，良性病变患者平均65岁（p<0.001）；恶性病变平均肿瘤直径3.2cm，良性病变2.9cm（p<0.001）。2014年至2022年间良恶性病变比例无显著变化（p=0.377）。多变量回归分析显示：年龄≥65岁（65-79岁[OR 1.881，p=0.002]、≥80岁[OR 3.642，p<0.001]）和肿瘤直径（OR 0.793，p<0.001）是良性病理的预测因素。本研究主要局限在于未能获取队列的穿刺活检率。 结论：本研究表明荷兰肾部分切除术后良性病理检出率较低（12%）。该比例是否可接受，或是否应更广泛采用肾肿瘤穿刺活检以减少过度治疗，仍需进一步探讨。

原文链接：

A National Study of the Rate of Benign Pathology After Partial Nephrectomy for T1 Renal Cell Carcinoma: Should We Be Satisfied?