Impact of tumor size on renal function after radical nephrectomy in patients with renal cell carcinoma

目的：了解肿瘤体积对于肾脏肿瘤行肾脏切除术后肾功能的影响。方法2009年1月至2013年8月81例患者，根据肿瘤最大径是否大于7 cm 分成两组，了解术前及术后肾功能变化情况及相关因素。结果肾功能恶化[肾小球滤过率（GFR）下降大于30％]在肿瘤直径≤7 cm 组发生率明显大于肿瘤直径﹥7 cm 组（32/45、71.1％及11/36、30.6％，P <0.0001），多因素相关分析显示患者的年龄（OR 1.05，P <0.001）、术前 GFR 值（OR 0.95，P <0.001）及肿瘤直径（OR 1.19，P =0.003）是术后肾功能恶化的显著性影响因素。结论患者的年龄、术前 GFR 值及肿瘤直径是肾肿瘤患者接受肾切除术后肾功能恶化的独立预测因素。Objective To investigate the impact of tumor size on postoperative glomerular filtration rate(GFR)in patients undergoing radical nephrectomy for renal cell carcinoma(RCC). Methods We analyzed GFR of 81 patients treated with radical nephrectomy for RCC. As-sociations of tumor size and clinical variables with renal function were analyzed. Results The incidence of GFR decrease ﹥ 30% was higher in patients with a tumor 7 cm or less(32 / 45,71. 1% )than in those with a tumor greater than 7 cm(11 / 36,30. 6% )( P < 0. 0001). Multivariate analysis revealed that age(OR1. 05,P < 0. 001),the preoperative GFR(OR 0. 95,P < 0. 001)and tumor size(OR1. 19,P = 0. 003)were significant risk factors for renal function deterioration. Conclusion Age,preoperative GFR and tumor size were significant risk factors for renal function deterioration in patients treated with radical nephrectomy.中国科技核心期刊(ISTIC)09743-74