Substantiation of Organ-Saving Operations in Renal Tumours
https://doi.org/10.24060/2076-3093-2018-8-2-5-9
Abstract
Purpose of the study: to analyse the results of organ-preserving operations in patients with localized renal cell carcinoma.
Materials and methods. The results of treatment of 458 patients who underwent organ-preserving treatment for renal cell carcinoma between 2009 and 2017 were analysed and evaluated. Of these, 286 were men (62.4 %) and 172 were women (37.6 %) with an average age of 54.7 ± 2.25 years (between 23 and 84 years).
Results. The size of the tumours ranged between two to eight centimetres (average tumour size 4.6 cm). The duration of “open” operations ranged from 30 to 110 minutes (average of 62 minutes); those using laparoscopy lasted between 85 and 180 minutes (average of 146 minutes). The volume of blood loss during the operation was an average of 133.6 ml (from 80 ml to 500 ml). In most patients, the tumour was in the first stage of the disease (443 cases, or 96.7 %). In 17 of patients operated on morphologically, invasion of paranephric fibre at the third stage (3.7 %) was detected. A further 8 patients had a second stage tumour more than 7 cm in size but without germination beyond the kidney (1.7 %). There were no cases of intra- or post-operative mortality. Discussion. No significant differences during the postoperative period were observed in patients undergoing “open” and laparoscopic surgery; the frequency of postoperative complications was also approximately the same in both cases.
Conclusion. Improvements in contemporary diagnostic methods have led to a sharp increase in the detection rate of small tumours. The results of studies comparing nephrectomy and kidney resection with a healthy contralateral kidney indicate the validity of the organ-preserving approach with small tumour sizes and localisation convenient for resection. In this regard, recently there has been a trend towards a wider use of kidney resection in renal cell carcinoma. Increased emphasis on the quality of life of cancer patients has led to an active study of the possibilities of using modern technologies in kidney cancer surgery.
About the Authors
K. Sh. Gantsev
Republican Clinical Oncology Centre;
Bashkir State Medical University
Russian Federation
Russian Federation
Doctor of Medical Sciences, Professor at the Department of Oncology, Oncologist at the Department of Urology No. 7,
73/1 Oktyabrya avenue, Ufa, 450054;
3 Lenin str., Ufa, 450006
Yu. N. Khrizman
Republican Clinical Oncology Centre
Russian Federation
Russian Federation
Candidate of Medical Sciences, Head of the Department of Urology No. 7, Oncologisturologist,
73/1 Oktyabrya avenue, Ufa, 450054
A. A. Khmelevskiy
Republican Clinical Oncology Centre;
Bashkir State Medical University
Russian Federation
Russian Federation
Post-graduate student at the Department of Oncology, Oncologist at the Department of Urology No. 7,
73/1 Oktyabrya avenue, Ufa, 450054;
3 Lenin str., Ufa, 450006
V. K. Shakurov
Republican Clinical Oncology Centre
Russian Federation
Russian Federation
Oncologist at the Department of Urology No. 7,
73/1 Oktyabrya avenue, Ufa, 450054
R. I. Aglyamov
Republican Clinical Oncology Centre
Russian Federation
Russian Federation
Oncologist-urologist at the Department of Urology No. 7,
73/1 Oktyabrya avenue, Ufa, 450054
References
1. Kaprin A.D., Starinskiy V.V., Petrova, G.V. (eds) Malignant neoplasms in Russia in 2016: morbidity and mortality. M., 2018. 250 p. (in Russ.)
2. Gorin M.A., Rowe S.P., Baras A.S., Solnes L.B., Ball M.W., Pierorazio P.M., et al. Prospective evaluation of 99mTc-sestamibi SPECT/ CT for the diagnosis of renal oncocytomas and hybrid oncocytic/ chromophobe tumors. Eur Urol. 2016;69(3):413–6. DOI: 10.1016/j.eururo.2015.08.056
3. Capitanio U., Terrone C., Antonelli A., Minervini A., Volpe A., Furlan M., et al. Nephron-sparing techniques independently decrease the risk of cardiovascular events relative to radical nephrectomy in patients with a T1a-T1b renal mass and normal preoperative renal function. Eur Urol. 2015;67(4):683–9. DOI: 10.1016/j.eururo.2014.09.027
4. Huang W.C., Levey A.S, Serio A.M., Snyder M., Vickers A.J, Raj G.V., et al. Chronic kidney cancer disease nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006;7(9):735–40. DOI: 10.1016/S1470-2045(06)70803-8
5. Minervini A., Rosaria Raspollini M., Tuccio A., Di Cristofano C., Siena G., Salvi M., et al. Pathological characteristics and prognostic effect of peritumoral capsule penetration in renal cell carcinoma after tumor enucleation. Urol Oncol. 2014;32(1):15–22. DOI: 10.1016/j.urolonc.2013.07.018
6. Rausch S., Gakis G., Bedke J., Stenzl A. Elective organ and function preservation in ureter and renal pelvis tumors. Urologe. 2014;53(9):1284–94. DOI: 10.1007/s00120-014-3557-6
7. Gantsev Sh.Kh., Kzyrgalin Sh.R., Gantsev K.Sh. Surgical methods of treatment in oncology: from expanded to minimally invasive operations. Practical Oncology. 2017;18(4):355–60. (in Russ.)
8. Dymochka M.A., Shakhsuvaryan S.B., Haumenko L.L., Krasnovskaya E.S., Vertash O.Yu. Cancer of a kidney: clinical characteristic, diagnostics, treatment, criteria of a quantitative estimation of a degree of functional impairments expressiveness in performing medical-social expertise. Medical-Social Problems of Disability. 2018;(1):59–67. (in Russ.)
9. Verze P., Fedelini P., Chiancone F., Cucchiara V., La Rocca R., Fedelini M., et al. Perioperative and renal functional outcomes of laparoscopic partial nephrectomy (LPN) for renal tumours of high surgical complexity: a single-institute comparison between clampless and clamped procedures. World J Urol. 2017;35(3):403–9. DOI: 10.1007/s00345-016-1882-7
10. Lugo-Baruqui J.A., Guerra G., Chen L., Burke G.W., Gaite J.A., Ciancio G. Living donor renal transplantation with incidental renal cell carcinoma from donor allograft. Transpl Int. 2015;28(9):1126–30. DOI: 10.1111/tri.12594
11. Padevit C., Sauck A., John H. Renal cell carcinoma: When is a partial, organ-preserving nephrectomy possible and reasonable?. Praxis. 2016;105(13):755–9. DOI: 10.1024/1661-8157/a002398
12. Shkodkin S.V., Fironov S.A., Idashkin Y.B., Lubushkin A.V., Nevsky A.A. The ways to reduce the intraoperative blood loss in renal cell carcinoma in patients with vena cava invasion. Experimental and Clinical Urology. 2016;(1):16–21. (in Russ.)
13. Indarokov T.R., Seregin A.V., Loran O.B., Shustitskiy N.A., Morozov A.D., Yandiev A.M., Bessolova O.V. Preventive hemostatic suture during open kidney resection as an option to preserve the renal function. Onkourologiya. 2017;13(3):39–45. DOI: 10.17650/1726-9776-2017-13-3-39-45 (in Russ.)
14. Ivakhno K.Y., Kipriyanov E.A., Vazhenin A.V., Karnaukh P.A. The results of organ-preserving treatment of patients with localized renal cell carcinoma according to the original methodology. Onkourologiya. 2017;13(2):36–42. DOI: 10.17650/1726-9776-2017-13-2-36- 42 (in Russ.)
15. Alyaev Yu.G., Rapoport L.M., Sirota E.S., Bezrukov E.A., Kondrashina A.V. Local recurrences after laparoscopic resections for renal parenchymal cancer. Andrology and Genital Surgery. 2017;18(4):61–8. DOI: 10.17650/2070-9781-2017-18-4-61-68 (in Russ.)
Review
For citations:
Gantsev K.Sh., Khrizman Yu.N., Khmelevskiy A.A., Shakurov V.K., Aglyamov R.I. Substantiation of Organ-Saving Operations in Renal Tumours. Creative surgery and oncology. 2018;8(2):89-93. (In Russ.) https://doi.org/10.24060/2076-3093-2018-8-2-5-9
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