Cancer UrologyCancer UrologyОнкоурология1726-97761996-1812Publishing House ABV Press68310.17650/1726-9776-2017-13-2-27-35DIAGNOSIS AND TREATMENT OF URINARY SYSTEM TUMORS. RENAL CANCERДИАГНОСТИКА И ЛЕЧЕНИЕ ОПУХОЛЕЙ МОЧЕПОЛОВОЙ СИСТЕМЫ. Рак почкиPartial nephrectomy for patients with a solitary kidneyРезекция единственной функционирующей почки при опухолях почечной паренхимыMatveevV. B.МатвеевВ. Б.
Russian Federation

заведующий урологическим отделением, профессор, член-корреспондент РАН

vsevolodmatveev@mail.ruVolkovaM. I.ВолковаМ. И.
Russian Federation

ведущий научный сотрудник урологического отделения, д.м.н.

mivolkova@rambler.ruAlborovS. V.АлборовСослан Валерьянович
Russian Federation

24 Kashirskoe Shosse, Moscow 115478,

Алборов Сослан Валерьянович - аспирант урологического отделения НИИ КО 

115478 Москва, Каширское шоссе, 24

a.s.alborov@mail.ruChernyaevV. A.ЧерняевВ. А.
Russian Federation
FigurinK. M.ФигуринК. М.
Russian Federation
RidinV. A.РидинВ. А.
Russian Federation
KuznetsovK. P.КузнецовК. П.
Russian Federation
NekhaevI. V.НехаевИ. В.
Russian Federation
LomidzeS. V.ЛомидзеС. Ф.
Russian Federation
GromovaE. G.ГромоваЕ. Г.
Russian Federation
KuznetsovaL. S.КузнецоваЛ. С.
Russian Federation
N.N. Blokhin Russian Cancer Reseach Center, Ministry of Health of RussiaФГБУ «Российский онкологический научный центр им. Н.Н. Блохина» Минздрава России3006201713227351805201727052017https://oncourology.abvpress.ru/oncur/article/view/683

Aim: to evaluate results of partial nephrectomy for patients with a solitary kidney performed at the N.N. Blokhin Cancer Center.

Materials and methods: medical data of 131 patients with solitary kidney tumors underwent partial nephrectomy at the Department of Urology of the N.N. Blokhin Russian Cancer Research Center from 1980 to 2015 were collected. Median age was 57 (26–75) years, a maleto-female ratio was 1:1.2. Median RENAL score was 7.0 ± 2.4. In all cases, chronic kidney disease was initially diagnosed (stage III – 30 (22.9 %), stage IV–V – 0 (0 %)). Median follow-up for all patients was 55 (6–386) months.

Results. The rate of intraoperative complications was 9.2 % (12/131), the rate of postoperative complications was 26.9 % (35/131) (severity grade II – 23 (17.6 %), III – 10 (7.7 %), IV – 1 (0.8 %), V – 1 (0.8 %)). Acute renal failure was observed in 69 (52.7 %) cases, acute dialysis was necessary in 6 (4.6 %) patients. Progression of chronic kidney disease was observed in 58 (44.6 %) patients, hemodialysis was demanded for 2 (1.5 %) patients. Histological study revealed renal cell carcinoma in 124 (94.6 %) samples, positive surgical margins were in 2 (1.5 %) samples. No local recurrences in the resection area were observed. Overall 5- and 10-year survival for all patients with renal cell carcinoma was 89.6 and 72.0 %, specific survival was 93.5 and 81.3 %, recurrence-free survival was 85.3 and 62.2 % respectively.

Conclusion. Partial nephrectomy is an effective method of treatment in of solitary kidney tumors associated with satisfactory functional and oncological outcome

Цель: изучение непосредственных и отдаленных результатов серии резекций единственной функционирующей почки, выполненной в РОНЦ им. Н.Н. Блохина. Материал: отобраны данные 131 пациента с опухолью почечной паренхимы единственной функционирующей почки, подвергнутого резекции в отделении урологии РОНЦ им. Н.Н. Блохина с 1980 по 2015 гг. Медиана возраста - 57,0 (26-75) лет, соотношение мужчин и женщин – 1:1,2. Медиана суммы баллов по нефрометрической шкале RENAL составила 7±2,4. Во всех случаях исходно установлен диагноз хронической болезни почек (ХБП) (ХБП ≥3 стадии - 30 (22,9%), ХБП 4-5 стадий – 0 (0,0%)). Медиана наблюдения за всеми пациентами составила 55 (6-386) месяцев. Результаты: частота интраоперационных осложнений – 9,2% (12/131), послеоперационных осложнений – 26,9% (35/131) (степень тяжести II - 23 (17,6%), III – 10 (7,7%), IV – 1 (0,8%), V – 1 (0,8%)). Острое снижение почечной функции зарегистрировано в 69 (52,7%) случаев и потребовало проведения острого диализа у 6 (4,6%) больных. Прогрессирование ХБП зарегистрировано у 58 (44,6%) больных, программный гемодиализ проводится 2 (1,5%) пациентам. Гистологическое исследование выявило рак почки в 124 (94,6%) образца, клетки опухоли по краю разреза имелись в 2 (1,5%) образцах. Местных рецидивов в зоне резекции не было. Пяти- и десятилетняя общая выживаемость всех больных раком почки составила 89,6% и 72,0%, специфическая – 93,5% и 81,3%, безрецидивная – 85,3% и 62,2% соответственно. Заключение: резекция единственной почки – эффективный метод лечения опухолей почечной паренхимы, обеспечивающий хорошие функциональные и онкологические результаты.

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