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China Muti-center RCC Treatment Analysis and PUMC RCC Database Buildup

Author: LiYaJian
Tutor: LiHanZhong
School: Beijing Union Medical College
Course: Clinical
Keywords: RCC epidemiology database
CLC: R737.11
Type: PhD thesis
Year: 2013
Downloads: 2
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Abstract


Objectives:1. By collecting RCC treatment related materials from2007to2011in urinary surgery departments of19hospitals, to analyze RCC epidemiology and changing treatment in recent5years.2. By collecting detailed treatment materials of patients in PUMC urinary surgery department from2002to2012, to analyze PUMC RCC treatment in recent10years. Then conclude our RCC treatment experience after comparing with other hospitals.3. To build up PUMC RCC database as a e-platform for scientific researches of our hospital and department.Method:RCC treatment related materials from2007to2011in other hospitals were input by doctors in their urinary surgery departments. There are8438cases in total, within which6853cases have provided integrated information for analyzing RCC epidemiology and changing treatment in recent5years, and whether any regional difference in RCC epidemiology and pathology. RCC patient treatment material collection of PUMC was done by me and other medical students with clinical experience. We have collected1638cases and1571cases are with integrated information. With those cases, I have concluded patients’characteristics by age, gender, native place, length of stay, cost, TNM stage, tumor location, operation method, vessel bleeding, complication, pathological diagnosis.Results:1. In6853patients of other hospitals, there are5238male and2641female (1.98:1). Their ages distribute from1to99, with an average of56.0±13.3. High incidence age is from47to68.3517cases (51.32%) belong to Suprarenal Epithelioma, which show much lower percentage compared with previous literature. The reason may be2926cases are without pathological diagnosis, thus cannot be classified.2. In1571patients of PUMC, there are1085male and486female (2.2:1). Their ages distribute from15to86, with an average of54.34±12.82. High incidence age is from45to60.1279cases (81.41%) belong to Suprarenal Epithelioma. And its high incidence age is44-58. There is no statistical difference between different regions in RCC incidence age and pathology. Neither is there any statistical difference between tumor locations.3. Asymptomatic patients have higher proportion, i.e.1169out of1571cases (74.41%) are asymptomatic, and other402cases (25.59%) are symptomatic. The percentage of asymptomatic patients is increasing year by year. Comparing asymptomatic with symptomatic patients, they have no significant difference in gender, age, tumor location and smoking history. But tumor diameters of asymptomatic patients are smaller, and they tend to have lower stage, shorter operation time, fewer days of stay, and lower cost (p<0.01).As a result, keep doing physical examination is very helpful for earlier discovering, diagnosing, and treating.4. Laparoscopic operation, is occupying a leading position in place of open operation. PUMC started laparoscopic operation clinically from2004, and its percentage gets higher than traditional open operation after2009. Compared with other hospitals, PUMC started earlier in laparoscopic operation. And it was spread faster and applied more. In comparison with traditional open operation, laparoscopic operation takes less time. Patients who took laparoscopic operation generally have less bleeding in operation, recover faster after operation, stay shorter time in hospital, spend less for treatment. And two ways of operation have no difference in influence to renal function (p<0.01)5. Different type of medical insurance will impact length of stay and treatment cost. Patients with state medical insurance and commercial health insurance always stay in hospital longer. And treatment cost of patients with new rural cooperative medical insurance is the highest among all.

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CLC: > Medicine, health > Oncology > Genitourinary tumors > Urinary tumors > Kidney,renal pelvis tumor
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