Analysis of the influence of radical nephrectomy compared with resection of the kidney on progression of chronic renal failure in patients with unilateral renal cancer P.23-26

S.M. Pasichnyk, Yu.B. Borys

Анотація


Aim. To evaluate the impact of radical nephrectomy compared with resection of the kidney on progression of chronic renal failure in patients with unilateral renal cell cancer. Material and Methods. The study included 103 patients with renal cell carcinoma. All patients were diagnosed with renal cell carcinoma - II stage and II - IV stage of chronic kidney failure. The first group included 42 (40,78%) patients who underwent radical nephrectomy. The second group consisted of 61 (59,22%) patients, who underwent kidney resection. The evaluation of the treatment was performed by examining, the progression of chronic renal failure after 3, 12 and 24 months after surgery. Results and Discussion. In 3 months after radical nephrectomy a significant progression of chronic renal failure was observed. In particular, 18 (42,8±10,0%) patients had chronic renal failure progression to stage III. In 12 months after operation, chronic renal failure progression was observed in most cases, and in one patient glomerular filtration rate indicators slightly improved, leading to chronic renal failure transition from stage III to stage II. In 24 months after treatment, progression of chronic renal observation, progression to stage III of chronic renal failure was observed in 22 patients (52,4±9,3%). In 3 months after kidney resection relatively slight progression of chronic renal failure was observed. In particular, only 6 (9,8%) patients showed progression to renal failure stage III. A similar situation was observed at 12 months follow-up. No patients were diagnosed with the final stage of renal failure. After 24 months following an organ surgery, chronic renal failure progression was observed in 17 (27,9±7,6%) patients, which was 24,5±12,0% lower than in patients who underwent radical nephrectomy. Conclusions. Data of a two-year follow-up suggest that the use of organ surgery, kidney resection in patients with I - II stage allows for 24,5%±12,0% reduction of the risk of chronic renal failure progression. Within 24 months of followup, final stage renal failure was observed only in 1 (1,6±1,6%) patient, which is not statistically reliable and does not affect the development of stage IV chronic renal failure in patients who underwent resection of the kidney for renal cell cancer. The most significant progression of chronic renal failure, observed in the first three months after surgery was found in patients who underwent radical nephrectomy. In this group, chronic renal failure progression to stage III was observed in 18 (42,8±10,0%) patients. Progression of chronic kidney failure within three months after performed kidney resection to stage III of chronic renal failure was relatively small and was observed in 6 (9.8%), which is 46,1±8,9% less compared to the group of patients who underwent radical nephrectomy. Key words: renal cell carcinoma, chronic renal failure, radical nephrectomy, resection of the kidney


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