Long-term results of surgical treatment for stage cT1 kidney cancer

2021 ◽  
Vol 23 (3) ◽  
pp. 133-140
Author(s):  
Sergey A. Rakul ◽  
Pavel N. Romashchenko ◽  
Kirill V. Pozdnyakov ◽  
Nikolay A. Maistrenko
Keyword(s):  
Overall Survival ◽  
Surgical Treatment ◽  
Partial Nephrectomy ◽  
Kidney Cancer ◽  
Radical Nephrectomy ◽  
Long Term Results ◽  
Positive Surgical Margin ◽  
Open Approach ◽  
Invasive Approach

Studied herein are the long-term results after surgical treatment of stage cT1 kidney cancer. The study includes 278 surgeries for kidney tumors. Partial nephrectomy was performed in 199 (71.6%) cases and radical nephrectomy in 79 (28.4%). Surgeries were performed using the open, laparoscopic, and robotic approaches. Surgical treatment and long-term oncological results were studied. Open approach for partial nephrectomy was used in 2.01% of cases, laparoscopic in 27.64%, and robotic in 70.34%; and radical nephrectomy in 2.53%, 87.34%, and 10.13%, respectively. Incidence postoperative complications after partial and radical nephrectomy were 16.58% and 3.8%, respectively. Сomplications (Clavien Dindo 3) occurred in 11.56% and 3.8% cases, respectively. Positive surgical margin occurred after partial nephrectomy in 1.51%, whereas undetermined for radical nephrectomy. The 5-year disease-free survival for partial and radical nephrectomy was 94.98 1.77% vs. 86.96% 4.11%; 5-year overall survival was 96.2% 1.55% vs. 88.15% 3.96%; 10-year overall survival was 90.82% 4.19% vs. 76.32 6.1%; and 5-year cancer-specific survival was 99.16% 0.84% vs. 94.09% 2.87%, respectively. Our study demonstrates that partial nephrectomy is a safe and effective method for surgical treatment in stage cT1 kidney cancer. A minimally invasive approach is a priority. The nephron-sparring technique demonstrates superior long-term results compared with radical nephrectomy.

scholarly journals Surgical management and prognostic factors in liver metastases from kidney cancer

2020 ◽  
Vol 25 (1) ◽  
pp. 18-26
Author(s):  
I. S. Proskuryakov ◽  
Yu. I. Patyutko ◽  
A. G. Kotelnikov ◽  
D. V. Podluzhny ◽  
A. N. Polyakov ◽  
...  
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Liver Metastases ◽  
Kidney Cancer ◽  
Univariate Analysis ◽  
Hepatic Metastases ◽  
Long Term Results ◽  
Maximum Diameter

Aim. To evaluate short- and long-term results of surgical treatment of the liver metastases from kidney cancer, to identify prognostic factors.Materials and methods. The retrospective study included 67 patients who underwent surgical treatment for liver metastases from kidney cancer from 1990 to 2019. A total of 71 operations on the liver were performed (53 economical resections, 15 extensive resections, 3 radiofrequency thermoablation). Four of them were repeated for the development of metastases in the liver remant.Results. Postoperative morbidity was 30%. There was one (1,5%) intraoperative death. Within 90 days after surgery, all patients were alive. The 5-year overall survival was 64%, median was 73 months. Univariate analysis revealed factors that significantly worsened overall survival: stage III and IV kidney cancer at the time of nephrectomy; nonclear cell histological type of metastases; synchronous liver metastases; intraoperative blood loss more than 2000 ml. Gender, age (≥ 65 years) at the time of surgery, number of metastases, maximum diameter of the metastases, presence of extrahepatic disease and major liver resection did not have a statistically significant impact on overall survival.Conclusions. Surgical treatment allows to achieve long-term overall survival of patients with liver metastases from kidney cancer. Higher indicators of overall survival were noted in the clear-cell variant of kidney cancer, stage I–II, and the metachronic nature of hepatic metastases. Patients with large (≥4 cm) and multiple resectable liver metastases, having solitary and single metastases in other organs, provided that they are radically removed, can also be considered as candidates for surgical treatment.

scholarly journals Surgical treatment of kidney cancer with extended inferior vena cava thrombosis: complications and long-term results

2017 ◽  
Vol 13 (1) ◽  
pp. 37-44 ◽  
Author(s):  
V. A. Atduev ◽  
Z. V. Amoev ◽  
A. A. Danilov ◽  
V. A. Bel’skiy ◽  
D. S. Ledyaev ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Inferior Vena Cava ◽  
Kidney Cancer ◽  
Inferior Vena ◽  
Vena Cava ◽  
Long Term Results ◽  
Vena Cava Thrombosis ◽  
Inferior Vena Cava Thrombosis

scholarly journals Partial vs. radical nephrectomy and the risk of all-cause mortality, cardiovascular, and nephrological outcomes

2020 ◽  
Vol 14 (10) ◽  
Author(s):  
Rodney H. Breau ◽  
Anil Kapoor ◽  
Danielle M. Nash ◽  
Neal Rowe ◽  
Octav Cristea ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Kidney Cancer ◽  
Radical Nephrectomy ◽  
Cardiovascular Events ◽  
Cardiovascular Outcomes ◽  
Partial Group ◽  
Radical Group ◽  
All Cause Mortality ◽  
Related Mortality

Introduction: The study’s objective was to examine the effects of renal preservation surgery on long-term mortality, cardiovascular outcomes, and renal-related outcomes. Methods: We performed a retrospective cohort study of all partial (n=575) and radical nephrectomies (n=882) for tumors ≤7 cm in diameter between 2002 and 2010 across three academic centers in Ontario, Canada. We linked records from provincial databases to assess patient characteristics and outcomes (median seven years’ followup using retrospective data). A weighted propensity score was used to reduce confounding. The primary outcome was all-cause mortality. Secondary outcomes included hospitalization with major cardiovascular events, non-cancer related mortality, kidney cancer-related mortality, and dialysis. Results: Mean one-year postoperative estimated glomerular filtration rate (eGFR) was 71 mL/min/1.73 m2 in the partial group and 52 mL/min/1.73 m2 in the radical group. Partial nephrectomy was associated with a lower risk of all-cause mortality in the first five years after surgery (hazard ratio [HR] 0.42; 95% confidence interval [CI] 0.27–0.66), which did not extend beyond five years (HR 1.01; 95% CI 0.68–1.49). Kidney cancer-related mortality was lower in the partial compared to the radical group for the first four years after surgery (HR 0.16; 95% CI 0.04–0.72). There were no significant differences between the groups for cardiovascular outcomes or non-cancer related deaths. Conclusions: Overall survival and cancer-specific survival was reduced in radical nephrectomy patients. However, despite reduced renal function in the radical nephrectomy group, non-cancer -related death, cardiovascular events, and dialysis were not significantly different between groups. Long-term benefits of partial nephrectomy may be less than previously believed.

scholarly journals Effect of Positive Surgical Margin on Survival After Partial Nephrectomy for Renal Cell Cancer: Long-term Results of a Single Center

2020 ◽  
Vol 7 (4) ◽  
pp. 316-324
Author(s):  
Mehmet Çağlar Çakıcı ◽  
Nihat Karakoyunlu ◽  
Alihan Kokurcan ◽  
Sercan Sarı ◽  
Fatih Sandıkçı ◽  
...  
Keyword(s):  
Partial Nephrectomy ◽  
Renal Cell Cancer ◽  
Renal Cell ◽  
Cell Cancer ◽  
Surgical Margin ◽  
Long Term Results ◽  
Positive Surgical Margin ◽  
Single Center

scholarly journals RETRACTED: Comparing Long-Term Outcomes Following Radical and Partial Nephrectomy for cT1 Renal Cell Carcinoma in Young and Healthy Individuals

2019 ◽  
Vol 3 (1) ◽  
Author(s):  
Wei Shen Tan ◽  
Sebastian Berg ◽  
Alexander P Cole ◽  
Marieke Krimphove ◽  
Maya Marchese ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Overall Survival ◽  
Cell Carcinoma ◽  
Partial Nephrectomy ◽  
Renal Cell ◽  
Radical Nephrectomy ◽  
Clinical Stage ◽  
Inverse Probability ◽  
Type Of Surgery

Abstract Background Despite randomized data demonstrating better overall survival favoring radical nephrectomy, partial nephrectomy continues to be the treatment of choice for low-stage renal cell carcinoma. Methods We utilized the National Cancer Database to identify patients younger than 50 years diagnosed with low-stage renal cell carcinoma (cT1) treated with radical nephrectomy or partial nephrectomy (2004–2007). Inverse probability of treatment weighting adjustment was performed for all preoperative factors to account for confounding factors. Kaplan-Meier curves and Cox proportional hazards regression analyses were used to compare overall survival of patients in the two treatment arms. Sensitivity analysis was performed to explore the interaction of type of surgery and clinical stage on overall survival. Results Among the 3009 patients (median age = 44 years [interquartile range (IQR) = 40–47 years]), 2454 patients (81.6%) were treated with radical nephrectomy and 555 patients (18.4%) with partial nephrectomy. The median follow-up was 108.6 months (IQR = 80.2–124.3 months) during which 297 patients (12.1%) in the radical nephrectomy arm and 58 patients (10.5%) in the partial nephrectomy arm died. Following inverse probability of treatment weighting adjustment, there was no difference in overall survival between patients treated with partial nephrectomy and radical nephrectomy (hazard ratio = 0.83, 95% confidence interval = 0.63 to 1.10, P = .196). There were no statistically significant interactions between type of surgery and clinical stage on treatment outcome. Conclusions There was no difference in long-term overall survival between radical and partial nephrectomy in young and healthy patients. This patient cohort may have sufficient renal reserve over their lifetime, and preserving nephrons by partial nephrectomy may be unnecessary.

scholarly journals Long-term results of surgical treatment of patients with retroperitoneal leiomyosarcoma

2020 ◽  
Vol 21 (4) ◽  
pp. 27-34
Author(s):  
Vladislav E. Bugaev ◽  
Maxim P. Nikulin ◽  
Sergey N. Nered ◽  
Ludmila N. Lyubchenko ◽  
Ivan S. Stilidi
Keyword(s):  
Overall Survival ◽  
Prognostic Factors ◽  
Surgical Treatment ◽  
Tumor Size ◽  
Combined Treatment ◽  
Disease Free Survival ◽  
Long Term Results ◽  
Free Survival ◽  
Disease Free

Relevance. Leiomyosarcomas is highly aggressive tumors with poor prognosis. Surgical resection is a standard treatment approach. However, data of long-term results of surgical treatment are lacking due to rarity of retroperitoneal form of leiomyosarcoma. Prognostic significance of tumor size, grade and recurrence type remains unclear as well. Aim. To analyze results of surgical treatment of patients with retroperitoneal leiomyosarcoma and to define prognostic factors which are associated with disease-free and overall survival. Materials and methods. The study included patients with primary retroperitoneal leiomyosarcomas who have received surgical or combined treatment between January 2003 and April 2019 at Blokhin National Medical Research Centre of Oncology. Short- and long-term clinical outcomes of surgical and combined treatment as well as recurrence rate, pattern of recurrence and morphological features were analyzed in order to define prognostic factors of disease-free and overall survival. Results. The study included 64 patients with primary retroperitoneal leiomyosarcomas 12 men (18%) and 52 women (82%). Median tumor size was 10.55.0 cm. Most of the operations (93.3%) were done by open approach. Combined resections were performed in 62.5% of cases (n=40), vascular resections in 17.2% cases (n=11). Radical (R0) resections were performed in 54 cases (85.9%). Postoperative morbidity and mortality rate were 39% and 0% respectively. Adjuvant chemotherapy or radiotherapy received 21 (35%) patients and 1 (1.7%) patient respectively. 46 (71.9%) patients had a disease recurrence. Recurrence type (local recurrence/distant metastases) did not influence overall survival (р=0.655). Median disease-free survival was 27 months (95% CI 1043.9). 3-year and 5-year disease-free survival was 43% and 21% respectively. Median overall survival was 79 months (95% CI 49108.9). 3-year and 5-year overall survival was 73% and 59% respectively. Among patients grade 2 and grade 3 tumors median disease-free survival was 49 vs. 18 months (р=0.271), median overall survival 146 vs. 58 months (р=0.018). There were no statistically significant differences in rate of radical resections among patients with different tumor location (р=0.804) or its size (р=0,520). Patients, who have undergone radical (R0) resection, had better overall (р=0.028) and disease-free survival (р0.001). Adjuvant chemotherapy was not associated lower risk of disease recurrence (p=0.976), type of recurrence (р=0.981) and lower overall survival (р=0.284). Conclusion. Tumor grade and radical resection are the most important prognostic factors in patients with retroperitoneal leiomyosarcoma. In our study, tumor size was not correlated with long-term results and possibility of radical resection.

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