Evaluation of patients who underwent radical nephrectomy due to renal tumor

Abstract

Abstract. The aim of the present study was to evaluate the results of the cases that underwent radical nephrectomy due to renal cell carcinoma (RCC) and to discuss the results together with the literature. Eighty-three patients (51 males), who underwent radical or partial nephrectomy because of renal tumor between 2005 and 2011 were retrospectively evaluated 70 patients underwent open radical nephrectomy and 13 patients underwent open partial nephrectomy. With regard of tumor localization, 50 were localized in the left and 33 were localized in the right kidney. Tumor sizes varied between 2 cm to 16 cm. According to the subtypes of RCC, five-year survival rate was 72% for clear cell, 80% for papillary carcinoma, 66.6% for chromophobe, and 71.4% for other malignant lesions. Five-year disease specific survival rates of the patients with T1, T2, T3, and T4 renal carcinoma were 91.3%, 87.5%, 50%, and 0%, respectively.

Radical nephrectomy is the standard method for the treatment of RCC. Survival rate in the patients with renal tumor is directly associated with the tumor stage.

Key words: Radical nephrectomy, tumor size, renal tumor, subtypes of RCC

Keywords

• Radical nephrectomy, tumor size, renal tumor, subtypes of RCC

References

1. Campbell SC, Novick A, Bukowski R. Renal Tumors. In: Campbell SC, Novick A, Bukowski R, eds. Campbell-Walsh Urology, 9th ed. Philadelphia, PA 19103-2899: Saunders Elsevier 2007; 1567-637.
2. Jacqmin D,Van Poppel H, Kirkali Z, Mickisch G. Renal cancer. Eur Urol 2001; 39: 361-370.
3. Linehan WM, Zbar B, Bates SE, Zelefsky MJ, Yang JC. Cancer of the kidney and ureter. In: DeVita VT Jr, Hellman S, Rosenberg SA, editors. Cancer: Principles and Practice of Oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2001; 1362-1396.
4. Levi F, Ferlay J, Galeone C, et al. The changing pattern of kidney cancer incidence and mortality in Europe. BJU Int 2008; 101: 949-958.
5. Tsui KH, Shvarts O, Smith RB, et al. Renal cell carcinoma: prognostic significance of incidentally detected tumors. J Urol 2000; 163: 426-430.
6. Novick AC, Campbell SC. Renal tumors. In: Walsh PC, Retik AB, Vaughan ED,Wein AJ, eds. Campbell’s Urology. Philadelphia: WB Saunders 2002; 2672-2731.
7. Chow WH, Devesa SS, Warren JL, Fraumeni JF Jr. Rising incidence of renal cell cancer in the United States. JAMA 1999; 281: 1628-1631.
8. Patard JJ, Leray E, Rodriguez A, et al. Correlation between symptom graduation,tumor characteristics and survival in renal cell carcinoma. Eur Urol 2003; 44: 226-232.

9. Heidenreich A, Ravery V. European Society of Oncological Urology. Preoperative imaging in renal cell cancer. World J Urol 2004; 22: 307-315.
10. Sheth S, Scatarige JC, Horton KM, Corl FM, Fishman EK. Current concepts in the diagnosis and management of renal cell carcinoma: role of multidetector CT and three-dimensional CT.Radiographics 2001; 21: 237-254.
11. Lim DJ, Carter MF. Computerized tomography in the preoperative staging for pulmonary metastases in patients with renal cell carcinoma. J Urol 1993; 150: 1112-1114.
12. Stin GP, Gross-Fengels W, Marincek B. The importance of magnetic resonance tomography in the diagnosis and staging of renal cell carcinoma. Radiologe 1992; 32: 121-126.
13. Krestin GP. Genitourinary MR: kidneys and adrenal glands. Eur Radiol 1999; 9: 1705-1714.
14. Kabala JE, Gillatt DA, Persad RA, et al. Magnetic resonance imaging in the staging ofrenal cell carcinoma. Br J Radiol 1991; 64: 683-689.
15. Hendriksson C, Haraldsson G, Aldenborg F, et al. Skeletal metastases in 102 patients evaluated before surgery for renal cell carcinoma. Scand J Urol Nephrol 1992; 26: 363-366.
16. Seaman E, Goluboff ET, Ross S, Sawczuk IS. Association of radionuclide bone scan and serum alkaline phosphatase in patients with metastatic renal cell carcinoma. Urology 1996; 48: 692-695.
17. Dechet CB, Zincke H, Sebo TJ, et al. Prospective analysis of computerized tomography and needle biopsy with permanent sectioning to determine the nature of solidrenal masses in adults. J Urol 2003; 169: 71-74.
18. Godley PA, Stinchcombe TE. Renal cellcarcinoma. Curr Opin Oncol 1999; 11: 213-217.
19. Bakal CW, Cynamon J, Lakritz PS, Sprayregen S. Value of preoperative renal artery embolization in reducing blood transfusion requirements during nephrectomy for renalncell carcinoma. J Vasc Interv Radiol 1993; 4: 727-773.
20. Hom D, Eiley D, Lumerman JH, et al. Complete renal embolization as an alternative to nephrectomy. J Urol 1999; 161: 24-27.
21. Margulis V, Wood CG. The role of lymph node dissection in renal cell carcinoma:the pendulum swings back. Cancer J 2008; 14: 308-314.
22. Lee CT, Katz J, Shi W, et al. Surgical management of renal tumors 4 cm or less in acontemporary cohort. J Urol 2000; 163: 730-736.
23. Desai MM, Strzempkowski B, Matin SF, et al. Prospective randomized comparison oftransperitoneal versus retroperitoneal laparoscopic radical nephrectomy. J Urol 2005; 173: 38-41.
24. Lewin JS, Nour SG, Connell CF, et al. Phase II clinical trial of interactive MR imaging-guided interstitial radiofrequency thermal ablation of primary kidney tumors: initial experience. Radiology 2004; 232: 835-845.
25. Lin CH, Moinzadeh A, Ramani AP, et al. Histopathologic confirmation of complete cancer-cell kill in excised specimens after renal cryotherapy. Urology 2004; 64: 590.
26. Flanigan RC, Salmon SE, Blumenstein BA, et al. Nephrectomy followed by interferon alfa-2b compared with interferon alfa-2b alone for metastatic renal-cell cancer. N Engl J Med 2001; 345: 165516
27. Fuhrman SA, Lasky LC, Limas C. Prognostic significance of morphologic parameters in renal cell carcinoma. Am J Surg Pathol 1982; 6: 655-663.
28. Thompson RH, Kurta JM, Kaag M, et al. Tumor size is associated with malignant potential in renal cell carcinoma cases. J Urol 2009; 181: 2033-2036.
29. Frank I, Blute ML, Cheville JC, et al. Solid renal tumors: an analysis of pathological features related to tumor size. J Urol 2003; 170: 2217-2220.
30. Patard JJ, Leray E, Rioux-Leclercq N, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. J Clin Oncol 2005; 23: 2763-2771.