腎部分切除術和腎癌根治術治療T1b期腎癌療效比較的Meta分析
發(fā)布時間：2018-11-23 13:26
【摘要】：目的：總結對側腎功能正常的T1b期腎癌患者行腎部分切除術和根治性腎切除術的療效差異，為臨床上T1b期腎癌患者在手術方式的選擇上提供循證學證據。 方法：首先采用電子與手工檢索對相關文獻進行初檢，進行電子檢索的數據庫有Pub med/Medlinedatabase、Cochrane圖書館、Embase、CNKI相關期刊論文、維普數據庫和萬方數字化期刊群，并通過各種主流搜索引擎查找與之相關文獻。對所有文獻進行嚴格的初步篩選，初選后獲取相關文獻全文，并采用Cochrane協(xié)作網推薦的偏倚風險評價工具對試驗進行評價。文獻數據由兩名研究者獨立提取，并采用RevMan5.1軟件進行Meta分析。 結果：按照嚴格的納入標準，最終腎部分切除術和腎癌根治術療效和安全性比較的臨床對照研究文獻共6篇，總共納入15740例患者，腎部分切除術組1841例，腎癌根治術組13926例。Meta分析結果示：（1）在6個研究中有4個試驗可以提取腎部分切除術和腎癌根治術關于術后5年總的生存率的比較的相關數據，經RevMan5.1軟件統(tǒng)計分析合并數據后得RR=1.02，95%CI=（0.94，1.12），P=0.00030.1，Z=0.54，腎部分切除術和腎癌根治術治療T1b期腎癌術后5年總生存率的差異無統(tǒng)計學意義。（2）在6個研究中有4個試驗可以提取腎部分切除術和腎癌根治術關于術后5年腫瘤特異性生存率比較的相關數據，經RevMan5.1軟件統(tǒng)計分析合并數據后得RR=1.11，95%CI=（1.04，1.18），P=0.80＞0.1，Z=3.24，腎部分切除術和腎癌根治術治療T1b期腎癌術后5年腫瘤的特異性生存率的差異有統(tǒng)計學意義。（3）在6個研究中有2個試驗可以提取腎部分切除術和腎癌根治術關于術后5年無瘤生存率比較的相關數據，經RevMan5.1軟件統(tǒng)計分析合并數據后得RR=0.67，95%CI=（0.19，2.4），，P=0.010.1，Z=0.61，認為腎部分切除術和腎癌根治術治療T1b期腎癌術后5年無瘤生存率的差異無統(tǒng)計學意義。（4）在6個研究中有2個試驗可以提取腎部分切除術和腎癌根治術關于術后腫瘤轉移情況的相關數據，經RevMan5.1軟件統(tǒng)計分析合并數據后得RR=0.21，95%CI=（0.18，0.51），P=0.76＞0.1，Z=3.38，認為腎部分切除術和腎癌根治術治療T1b期腎癌術后轉移情況的差異有統(tǒng)計學意義。 結論：以上結果表明：兩種手術方式術后患者5年總的生存率、5年無瘤生存率差別無統(tǒng)計學意義；腎部分切除術組術后5年腫瘤特異性生存率優(yōu)于腎癌根治術組，腎部分切除術組比腎癌根治術組術后更容易合并腫瘤轉移。
[Abstract]:Objective: to summarize the difference between partial nephrectomy and radical nephrectomy in patients with stage T 1b renal carcinoma with normal contralateral renal function, and to provide evidence for the choice of surgical methods in patients with stage T 1b renal carcinoma. Methods: first of all, electronic and manual retrieval was used to check the related documents. The databases of electronic retrieval included Pub med/Medlinedatabase,Cochrane library, Embase,CNKI full text database of Chinese periodicals, Weipu database and Wanfang digital periodical group. And through a variety of mainstream search engines to find relevant literature. After the primary selection, the full text of the relevant literature was obtained, and the bias risk assessment tool recommended by Cochrane Cooperative Network was used to evaluate the experiment. The literature data were extracted independently by two researchers and Meta analysis was carried out with RevMan5.1 software. Results: according to the strict inclusion criteria, there were 6 clinical comparative studies on the efficacy and safety of the final partial nephrectomy and radical nephrectomy. A total of 15740 patients were included in the study, 1841 in the partial nephrectomy group. The results of Meta analysis showed that: (1) four of the 6 studies could extract the data from partial nephrectomy and radical nephrectomy on the overall 5-year survival rate. The RR=1.02,95%CI= (0.94m1.12), P0. 00030. 1 and ZX 0. 54 were obtained by statistical analysis of the combined data by RevMan5.1 software. There was no significant difference in 5-year overall survival rate between partial nephrectomy and radical nephrectomy for stage T 1b renal cell carcinoma. (2) four of the six studies could extract partial nephrectomy and radical nephrectomy. 5 year tumor-specific survival rate data, The RR=1.11,95%CI= (1.04m1.18), P0. 80 > 0. 1GZ 3. 24 were obtained by statistical analysis of the data by RevMan5.1 software. There was significant difference between partial nephrectomy and radical nephrectomy in the treatment of T1b stage renal cell carcinoma. (3) two of the 6 studies can extract partial nephrectomy and radical nephrectomy. (3) in 6 studies, two tests can be used to extract partial nephrectomy and radical nephrectomy. The relevant data of postoperative 5-year tumor-free survival rate, RR=0.67,95%CI= (0.19 ~ 2.4), P ~ (0.010. 1) ~ (Z) ~ (0.61), P ~ (0.010. 1) ~ (2 +) were obtained by statistical analysis of data by RevMan5.1 software. It is concluded that there is no significant difference between partial nephrectomy and radical nephrectomy in the treatment of T1b stage renal cell carcinoma. (4) two of the 6 studies can extract partial nephrectomy and radical nephrectomy. The relevant data of tumor metastasis after operation, RR=0.21,95%CI= (0.18 鹵0.51) and P _ (0.76) > 0.1 ~ (1) Z ~ (3. 38) were obtained by RevMan5.1 software. It is concluded that there is a significant difference between partial nephrectomy and radical nephrectomy in the treatment of stage T 1b renal cell carcinoma after operation. Conclusion: the above results indicate that there is no significant difference in 5-year overall survival rate and 5-year tumor-free survival rate between the two surgical methods. The 5-year tumor specific survival rate of partial nephrectomy group was better than that of radical nephrectomy group, and partial nephrectomy group was more likely to be associated with tumor metastasis than that of radical nephrectomy group.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R737.11
本文編號：2351764
[Abstract]:Objective: to summarize the difference between partial nephrectomy and radical nephrectomy in patients with stage T 1b renal carcinoma with normal contralateral renal function, and to provide evidence for the choice of surgical methods in patients with stage T 1b renal carcinoma. Methods: first of all, electronic and manual retrieval was used to check the related documents. The databases of electronic retrieval included Pub med/Medlinedatabase,Cochrane library, Embase,CNKI full text database of Chinese periodicals, Weipu database and Wanfang digital periodical group. And through a variety of mainstream search engines to find relevant literature. After the primary selection, the full text of the relevant literature was obtained, and the bias risk assessment tool recommended by Cochrane Cooperative Network was used to evaluate the experiment. The literature data were extracted independently by two researchers and Meta analysis was carried out with RevMan5.1 software. Results: according to the strict inclusion criteria, there were 6 clinical comparative studies on the efficacy and safety of the final partial nephrectomy and radical nephrectomy. A total of 15740 patients were included in the study, 1841 in the partial nephrectomy group. The results of Meta analysis showed that: (1) four of the 6 studies could extract the data from partial nephrectomy and radical nephrectomy on the overall 5-year survival rate. The RR=1.02,95%CI= (0.94m1.12), P0. 00030. 1 and ZX 0. 54 were obtained by statistical analysis of the combined data by RevMan5.1 software. There was no significant difference in 5-year overall survival rate between partial nephrectomy and radical nephrectomy for stage T 1b renal cell carcinoma. (2) four of the six studies could extract partial nephrectomy and radical nephrectomy. 5 year tumor-specific survival rate data, The RR=1.11,95%CI= (1.04m1.18), P0. 80 > 0. 1GZ 3. 24 were obtained by statistical analysis of the data by RevMan5.1 software. There was significant difference between partial nephrectomy and radical nephrectomy in the treatment of T1b stage renal cell carcinoma. (3) two of the 6 studies can extract partial nephrectomy and radical nephrectomy. (3) in 6 studies, two tests can be used to extract partial nephrectomy and radical nephrectomy. The relevant data of postoperative 5-year tumor-free survival rate, RR=0.67,95%CI= (0.19 ~ 2.4), P ~ (0.010. 1) ~ (Z) ~ (0.61), P ~ (0.010. 1) ~ (2 +) were obtained by statistical analysis of data by RevMan5.1 software. It is concluded that there is no significant difference between partial nephrectomy and radical nephrectomy in the treatment of T1b stage renal cell carcinoma. (4) two of the 6 studies can extract partial nephrectomy and radical nephrectomy. The relevant data of tumor metastasis after operation, RR=0.21,95%CI= (0.18 鹵0.51) and P _ (0.76) > 0.1 ~ (1) Z ~ (3. 38) were obtained by RevMan5.1 software. It is concluded that there is a significant difference between partial nephrectomy and radical nephrectomy in the treatment of stage T 1b renal cell carcinoma after operation. Conclusion: the above results indicate that there is no significant difference in 5-year overall survival rate and 5-year tumor-free survival rate between the two surgical methods. The 5-year tumor specific survival rate of partial nephrectomy group was better than that of radical nephrectomy group, and partial nephrectomy group was more likely to be associated with tumor metastasis than that of radical nephrectomy group.
【學位授予單位】：石河子大學
【學位級別】：碩士
【學位授予年份】：2013
【分類號】：R737.11
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