Some ways of improving long-term results of treatment for renal cancer

Abstract

Objective: to estimate the incidence of local recurrences and distant metastases, and the long-term results of treatment for renal cancer (RC) in relation to the used treatment option and surgical access.

Subjects and methods. The results of treatment were analyzed in 392 patients with RC, by using the 1993-to-2000 materials of the municipal cancer dispensary and other Kazan therapeutic-and-prophylactic institutions.

Results. With a laparotomic access, there were no local recurrences in any patients whereas with a lumbar access, local recurrence rate was 25%, which is, in the authors' opinion, associated with the disintegration of Gerota's fascia and with the spread of cancer cells. With the application of lumbotomic and transabdominal accesses, the incidence of metachronous distant metastases was 38.9 and 15.1%, respectively. With the laparatomic access, 3- and 5-year survival was also 10—20% higher than that with the lumbotomic access. Postoperative radiotherapy and/or hormonotherapy does not affect the incidence of local recurrences and distant metastases at all stages of the disease.

Conclusion. Midline laparotomy with hardware access correction with Sigal-Kabanov retractors (SKR-10) should be considered to be the access of choice in treating RC.