The results of organ-preserving treatment of patients with localized renal cell carcinoma according to the original methodology
https://doi.org/10.17650/1726-9776-2017-13-2-36-42
Abstract
The article presents results of treatment of patients with localized renal cell carcinoma using the original technique of open partial nephrectomy. This technique involves the use of intraoperative ultrasonoscopy to define and mark the boundaries of the tumor and the method of creating a zone of local ischemia to resection the tumor without the use of total renal ischemia. The developed methodology in the comparative analysis of the immediate and remote results significantly (p > 0.05) reduces the amount of intraoperative blood loss without increasing the duration of the operation, reduces the risk of development of acute disorders of renal function in the early postoperative period, without compromising kidney function in the late postoperative period. This technique is comparable to the classical open radical resection of the kidney, does not affect the overall, oncospecific and relapse-free survival.
About the Authors
K. Yu. IvakhnoRussian Federation
42 Blukhera St., Chelyabinsk 454087
E. A. Kipriyanov
Russian Federation
A. V. Vazhenin
Russian Federation
P. A. Karnaukh
Russian Federation
References
1. Злокачественные новообразования в России в 2013 году (заболеваемость и смертность). Под ред. А.Д. Каприна, В.В. Старинского, Г.В. Петровой. М.: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИРЦ» Минздрава России, 2015. С. 11–134. [Malignant tumors in Russia in 2013 (morbidity and fatality). Eds. А.D. Kaprin, V.V. Starinskiy, G.V. Petrova. Мoscow: MNIOI im. P.A. Gertsena – filial FGBU “NMIRTS” Minzdrava Rossii, 2015. Pp. 11–134. (In Russ.)].
2. Матвеев В.Б. Органосохраняющее лечение при раке почки. В кн.: Клиническая онкоурология. М.: Вердана, 2003. С. 64– 68. [Matveev V.B. Organ preservation in treatment of renal cancer. In book: Clinical Oncourology. Moscow: Verdana, 2003. Pp. 64–68. (In Russ.)].
3. Van Poppel H., da Pozzo L., Albrecht W. et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephronsparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur Urol 2011;59:543–52.
4. Becker F., Siemer S., Humke U. et al. Elective nephron sparing surgery should become standard treatment for small unilateral renal cell carcinoma: longterm survival data of 216 patients. Eur Urol 2006;49(2):308–13. DOI: 10.1016/j.eururo.2005.10.020. PMID: 16359779.
5. Patard J.J., Shvarts O., Lam J.S. et al. Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urol 2004;171(6 Pt 1): 2181–5. PMID: 15126781.
6. Huang W.C., Levey A.S., Serio A.M. et al. Chronic kidney disease after 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. PMID: 16945768.
7. Thompson R.H., Boorjian S.A., Lohse C.M. et al. Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. J Urol 2008;179(2):468–71. DOI: 10.1016/j.juro.2007.09.077. PMID: 18076931.
8. Аляев Ю.Г., Амосов А.В., Газимиев М.А. Ультразвуковые методы функциональной диагностики в урологической практике. М., 2001. С. 192. [Alyaev Yu.G., Amosov A.V., Gazimiev M.A. Ultrasound methods of functional diagnosis in urological practice. Moscow, 2001. P. 192. (In Russ.)].
9. Aliaev Iu.G., Sapin M.R., Bocharov V. et al. Scope of lymphadenectomy in organ-sparing operations in kidney cancer patients. Urologiа 2003;(2):3–7. 10. Campbell S.C., Novick A.C., Belldegrun A. et al. Guideline for management of the clinical T1 renal mass. J Urol 2009;182(4):1271–9. DOI: 10.1016/j.juro.2009.07.004. PMID: 19683266.
10. Remzi M., Javadli E., Ozsoy M. Management of small renal masses: a review. World J Urol 2010;28(3):275–81. DOI: 10.1007/s00345-010-0516-8. PMID: 20177900.
11. Vogelzang N.J., Stadler W.M. Kidney cancer. Lancet 1998;352(9141):1691–6. DOI: 10.1016/S0140-6736(98)01041-1. PMID: 9853456.
12. Kim S.P., Thompson R.H., Boorjian S.A. et al. Comparative effectiveness for survival and renal function of partial and radical nephrectomy for localized renal tumors: a systematic review and metaanalysis. J Urol 2012;188(1):51–7. DOI: 10.1016/j.juro.2012.03.006. PMID: 22591957.
13. Go A.S., Chertow G.M., Fan D. et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N Engl J Med 2004;351(13):1296–305. DOI: 10.1056/NEJMoa041031. PMID: 15385656.
14. Lane B.R., Babineau D.C., Poggio E.D. et al. Factors predicting renal functional outcome after partial nephrectomy. J Urol 2008;180(6):2363–8;discussion. DOI: 10.1016/j.juro.2008.08.036. PMID: 18930264.
15. Abreu A.L., Gill I.S., Desai M.M. Zero-ischaemia robotic partial nephrectomy (RPN) for hilar tumours. BJU Int 2011;108(6 Pt 2):948–54. DOI: 10.1111/j.1464-410X.2011.10552.x. PMID: 21917096.
16. Simone G., Gill I.S., Mottrie A. et al. Indications, techniques, outcomes, and limitations for minimally ischemic and off-clamp partial nephrectomy: a systematic review of the literature. Eur Urol 2015;68(4):632–40. DOI: 10.1016/j.eururo.2015.04.020. PMID: 25922273.
Review
For citations:
Ivakhno K.Yu., 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. Cancer Urology. 2017;13(2):36-42. (In Russ.) https://doi.org/10.17650/1726-9776-2017-13-2-36-42