RESULTS OF NEPHRON-SPARING SURGERY OF INTRAPARENCHYMAL RENAL TUMORS
2020
Surgical treatment is the main therapy for patients with renal cell carcinoma. The current approach in the treatment of kidney tumours has become widely introduced into nephron-sparing surgery. This approach is usually applied in cases of complex surgeries for large-size tumours with intravenous extension, multifocal, and intraparenchymal renal tumours. The purpose of the study was to investigate the results of nephron-sparing surgery for intraparenchymal renal tumours. Material and methods. The results were obtained in the process of nephron-sparing surgery treatment of 701 patients with renal tumours. After the distribution of all patients according to the criterion of "intraparenchymal renal tumours", we assessed 27 (3,9%) cases of nephron-sparing surgery. There were also 674 (96,1%) patients with exophytic renal tumors. Results. We managed to obtain the information about long-term treatment outcomes from 606 (86.4%) patients. There were 25 (4,1%) patients with intraparenchymal renal tumors. The observation of patients showed that there were cases of death and disease progression for various reasons during 46.5±2.1 months on average. The results of the comparative statistical analysis showed that the 5-year overall survival among patients with intraparenchymal renal tumors made up 88.0% of the cases and among the patients with exophytic renal tumors it was 94.8%. The differences were not significant (p> 0.430). At the same time, the 5-year overall progression-free survival was obtained in 88.9% of the patients with intraparenchymal renal tumors and in 95.2% (p <0.041) of patients with exophytic renal tumors. Conclusion. The problem of nephron-sparing treatment of intraparenchymal renal tumors is an urgent issue. Research has shown that such tumors are complex for nephron-sparing surgery, require complex treatment technologies that affect surgical results. At the same time, positive oncological results demonstrate that nephron-sparing treatment is an effective method of treating fully intraparenchymal renal tumors.
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