ROLE OF LYMPHDISSECTION IN THE SURGICAL TREATMENT OF RENAL-CELL CARCINOMA,

Abstract

Background: to define interrelation of lymphdissection at radical nephrectomy in surgical treatment of renal cell carcinoma (RCC).

Materials and methods: 221 patients were investigated with RCC. The men — 119, women — 102. Middle age of patients has made 53,3 years. T1 stage in 16 patients (7.3 %), T2 — in 55 patients (24.8 %), T3-133 (60.2%), T4-17(7.7%) patients. N1 occurred in 22 (9.9 %) patients, N2 in 8 (3.6 %), N0 in 191 (86.5 %) patients. Patients were divided into 2 groups depending on volume of lymphdissection, with the period of supervision of 3 years.

Results: Group I. Simple nephrectomy was executed in 130 patients without removal of regional lymph nodes. Metastases during the postoperative period occurred in the remote organs in 25.1 % cases, loco-regional metastasis in lymph nodes in 3.8 % cases was revealed, relapse 3%. Average life expectancy has made 25,6 months (of calculation 3 years). Group II. Nephrectomy with expanded lymphdissection from legs of a diaphragm to bifurcation of illiac arteries by midline approach was performed in 91 patients. On pathogistological research, metastases in regional lymph node was revealed in 15.3 % cases. Metastases during the postoperative period occurred in the remote organs in 6.6 % cases, metastasises in kept away lymph node in 1.08 % cases was revealed, relapse 3,2%. Average life expectancy has made 33,4 months (of calculation 3 years).

Conclusion: we have come to opinion on inexpediency of performance usual nephrectomy on RCC. Application expanded lymphdissection from from legs of a diaphragm to bifurcation of illiac arteries is improved by the remote results.Напоминаем