Результаты органосохраняющего лечения при почечно-клеточном раке

Objective: The immediate and long-term results of nephron-sparing treatment for renal-cell carcinoma (RCC) were retrospectively assessed. The impact of several prognostic factors on treatment results was analyzed.Material and Methods: All cases of partial nephrectomy in RCC performed at the N.N. Alexandrov Research Institute of Oncology and Medical Radiology in 1993 and 2005 were collected. The data on the patients' deaths were selected from the Byelorussian cancer register. Mono- and multivariant analyses were made by using the Kaplan-Meier method and the Cox proportional hazard model.Results: A total of 298 operations were performed in 292 patients, 271 being in RCC. Complications developed in 5.5% of the patients. The follow-up averaged 30.0±28.2 months. A local relapse was diagnosed in 4 (1.5%) patients. Five- and 10-year crude survival rate was 87.2%. The results of partial nephrectomy in pT3a tumors more than 4 cm were found significantly worse than those in pT1-2 and pT3a 4 cm or less (p = 0.03). The Cox proportional hazard model revealed the significance of pT, size and grade combination (p = 0.03). Three groups of patients were formed by the significantly different 10-year survival rates.Conclusion: Partial nephrectomy is a safe and effective treatment for localized RCC. Elective operation can be performed in patients with T3a RCC 4 cm or less. It is possible to divide patients into 3 prognostic groups with different survival rates in relation to the treatment results in pT, tumour size and grade.

Симультанное хирургическое лечение больных почечно-клеточным раком с конкурирующей патологией сердца

The authors analyze the immediate results of 8 simultaneous operations, 4 of these under conditions of artificial circulation, in patients with renal cell carcinoma concomitant with heart diseases. The immediate results were satisfactory, with good functional parameters. Due to simultaneous operations the incidence of intra- and postoperative cardiovascular complications is reduced, the progress of the tumor process between different stages of treatment is arrested, early radical interventions for tumor removal becomes possible, and the hospitalization period is shorter in comparison with staged operations.

Simultaneous Surgical Treatment of Patients with Renal Cell Carcinoma Concomitant with Heart Disease

The authors analyze the immediate results of 8 simultaneous operations, 4 of these under conditions of artificial circulation, in patients with renal cell carcinoma concomitant with heart diseases. The immediate results were satisfactory, with good functional parameters. Due to simultaneous operations the incidence of intra- and postoperative cardiovascular complications is reduced, the progress of the tumor process between different stages of treatment is arrested, early radical interventions for tumor removal becomes possible, and the hospitalization period is shorter in comparison with staged operations