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Renal Hücreli Kanser Nedeniyle Radikal Ve Parsiyel Nefrektomi Yapılan Hastaların Onkolojik Sonuçlarının Karşılaştırılması

Year 2019, Volume: 9 Issue: 2, 326 - 336, 28.06.2019
https://doi.org/10.31832/smj.543504

Abstract


Amaç:
Bu
çalışmada renal hücreli karsinom (RHK) nedeniyle radikal ve
parsiyel nefrektomi yapılan hastaların evrelere göre onkolojik
sonuçlarının karşılaştırılması amaçlanmıştır. Bu amaçla
klinikopatolojik özelliklerin rekürrenssiz sağkalım ve kansere
özgü sağkalım üzerine etkileri incelendi.







Materyal-Metod:
2004-2012
tarihleri arasında renal kitle nedeniyle kliniğimizde
parsiyel/radikal nefrektomi uygulanan T3a ve altındaki 200 hastanın
verilerini retrospektif olarak inceledik. Klinikopatolojik
özelliklerin sağkalımlara üzerine istatistiksel etkileri olup
olmadığı Log-Rank testi kullanılarak Kaplan Meier sağkalım
analizi ile değerlendirildi. Her bir değişkene ilişkin 1- 3 ve 5
yıllık sağkalım hızları, ortalama yaşam süresi ve bu süreyle
ilişkili %95 güven aralıkları hesaplandı.







Bulgular:
Tüm
olgular içerisinde 1- 3 ve 5 yıllık rekürrenssiz sağkalım %
95.5, 90.5 ve 85.5, kansere özgü sağkalım % 98.8, 96.4 ve 92.3
olarak tespit edildi. PN grubunda RN grubuna göre rekürrenssiz
sağkalım istatistiksel olarak daha yüksekti (p=0,014) ama kansere
özgü sağkalımda fark gözlenmedi. Evrelere göre T1a, T1b ve T3a’
da rekürrrenssiz sağkalım ve kansere özgü sağkalım T2a ve T2b’
den daha yüksekti (p=0,023 ve p<0,001). T1a ve T1b evrelerinde 1-
3 ve 5 yıllık rekürrenssiz sağkalım ve kansere özgü sağkalım
benzer olarak bulundu ve klinikopatolojik özelliklerle istatistiksel
olarak ilişki tespit edilmedi. Tüm olgular içerisinde patolojik
tümör boyutu (p=0,026) ve diğer (Toplayıcı kanal karsinomu)
histolojinin (p<0,001) rekürrenssiz sağkalımı etkilediği
görüldü. Tüm olgular içerisinde multivariate analizlerde yaş
(p=0,010) ve patolojik tümör boyutunun (p=0,018) kansere özgü
sağkalımı etkilediği görüldü.







Sonuç:
T1a
ve T1b böbrek tümörlerinde parsiyel nefrektomi ve radikal
nefrektomi yapılan hastalar arasında rekürrenssiz ve kansere özgü
sağkalımların benzer olduğu gözlendi ve prognozunun herhangi bir
klinikopatolojik özellikten etkilenmediği gözlendi.
Klinikopatolojik ve demografik özelliklerin ileri evrelerde
sağkalımla ilişkili olabileceği düşünüldü.

References

  • 1-Wolf JS, Jr. Evaluation and management of solid and cystic renal masses. J Urology. 1998;159(4):1120-33.
  • 2-Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Five-year survival after surgical treatment for kidney cancer: a population-based competing risk analysis. Cancer. 2007;109(9):1763-8.
  • 3-Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urology. 2000;163(2):442-5.
  • 4-Huang WC, Elkin EB, Levey AS, Jang TL, Russo P. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors-- is there a difference in mortality and cardiovascular outcomes? J Urology. 2009;181(1):55-61.
  • 5-Hamilton ZA, Capitanio U, Lane BR, Larcher A, Yim K,Dey S et al. Should partial nephrectomy be considered “elective” in patients with stage 2 chronic kidney disease? A comparative analysis of functional and survival outcomes after radical and partial nephrectomy. World journal of urology, 2019;1-9.
  • 6-American Urological Association. Guideline for management of the clinical stage 1 renal mass [Internet], 2009, http://www.auanet.org/ guidelines/archived-documents (2010, accessed 19 March 2018).
  • 7-European Association of Urology. Guidelines on renal cell carcinoma [Internet]. http://uroweb. org/guideline/renal-cell-carcinoma/?type=archive (2010, accessed 19 March 2018).
  • 8- Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, Scardino PT, Russo P. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 2006; 7: 735- 740.
  • 9- Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS; Urologic Diseases in America Project. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer 2008; 112: 511-520.
  • 10- Thompson RH, Siddiqui S, Lohse CM, Leibovich BC, Russo P, Blute ML. Partial versus radical nephrectomy for 4 to 7 cm renal cortical tumors. J Urol 2009; 182: 2601-2606.
  • 11-Chow WH, Devesa SS, Warren JL, Fraumeni JF, Jr. Rising incidence of renal cell cancer in the United States. JAMA : the journal of the American Medical Association. 1999;281(17):1628-31.
  • 12-Aaltomaa S, Lipponen P, Ala-Opas M, Eskelinen M, Syrjanen K. Prognostic value of Ki-67 expression in renal cell carcinomas. European Urology. 1997;31(3):350-5.
  • 13-Furniss D, Harnden P, Ali N, Royston P, Eisen T, Oliver RT, et al. Prognostic factors for renal cell carcinoma. Cancer treatment reviews. 2008;34(5):407-26.
  • 14-Bengió RG, Arribillaga LC, Epelde J, Orellana S, Montedoro A, Bengió VM, et al. Evaluation of microvascular invasion as a prognostic factor in the progression of non-metastatic renal cancer. Central European journal of urology,2018;71(4), 386.
  • 15-Guinan PD, Vogelzang NJ, Fremgen AM, Chmiel JS, Sylvester JL, Sener SF, et al. Renal cell carcinoma: tumor size, stage and survival. Members of the Cancer Incidence and End Results Committee. J Urology. 1995;153(3 Pt 2):901-3.
  • 16-Verhoest G, Avakian R, Bensalah K, Thuret R, Ficarra V, Artibani W, et al. Urinary collecting system invasion is an independent prognostic factor of organ confined renal cell carcinoma. J Urology. 2009;182(3):854- 9.
  • 17-Siddiqui SA, Frank I, Leibovich BC, Cheville JC, Lohse CM, Zincke H, et al. Impact of tumor size on the predictive ability of the pT3a primary tumor classification for renal cell carcinoma. J Urology. 2007;177(1):59-62.
  • 18-Leibovich BC, Blute M, Cheville JC, Lohse CM, Weaver AL, Zincke H. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J of Urology. 2004;171(3):1066-70.
  • 19-Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Solid renal tumors: an analysis of pathological features related to tumor size. J Urology. 2003;170(6 Pt 1):2217-20.
  • 20-Patard JJ, Shvarts O, Lam JS, Pantuck AJ, Kim HL, Ficarra V, et al. Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urology. 2004;171(6 Pt 1):2181-5.
  • 21-Lau WK, Cheville JC, Blute ML, Weaver AL, Zincke H. Prognostic features of pathologic stage T1 renal cell carcinoma after radical nephrectomy. Urology. 2002;59(4):532-7.
  • 22-Lee LS, Yuen JS, Sim HG. Renal cell carcinoma in young patients is associated with poorer prognosis. Annals of the Academy of Medicine, Singapore. 2011;40(9):401-6.
  • 23-May M, Aziz A, Zigeuner R, Chromecki T, Cindolo L, Schips L, et al. Gender differences in clinicopathological features and survival in surgically treated patients with renal cell carcinoma: an analysis of the multicenter CORONA database. World J urol. 2013.
  • 24-Tsui KH, Shvarts O, Smith RB, Figlin RA, deKernion JB, Belldegrun A. Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria. J Urology. 2000;163(4):1090-5.
  • 25-Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: the SSIGN score. J Urology. 2002;168(6):2395-400.
  • 26-Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2005;23(12):2763-71.
  • 27-Leibovich BC, Lohse CM, Crispen PL, Boorjian SA, Thompson RH, Blute ML, et al. Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. J Urology. 2010;183(4):1309-15.
  • 28-Teloken PE, Thompson RH, Tickoo SK, Cronin A, Savage C, Reuter VE, et al. Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma. J Urology. 2009;182(5):2132-6.
Year 2019, Volume: 9 Issue: 2, 326 - 336, 28.06.2019
https://doi.org/10.31832/smj.543504

Abstract

References

  • 1-Wolf JS, Jr. Evaluation and management of solid and cystic renal masses. J Urology. 1998;159(4):1120-33.
  • 2-Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Five-year survival after surgical treatment for kidney cancer: a population-based competing risk analysis. Cancer. 2007;109(9):1763-8.
  • 3-Fergany AF, Hafez KS, Novick AC. Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. J Urology. 2000;163(2):442-5.
  • 4-Huang WC, Elkin EB, Levey AS, Jang TL, Russo P. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors-- is there a difference in mortality and cardiovascular outcomes? J Urology. 2009;181(1):55-61.
  • 5-Hamilton ZA, Capitanio U, Lane BR, Larcher A, Yim K,Dey S et al. Should partial nephrectomy be considered “elective” in patients with stage 2 chronic kidney disease? A comparative analysis of functional and survival outcomes after radical and partial nephrectomy. World journal of urology, 2019;1-9.
  • 6-American Urological Association. Guideline for management of the clinical stage 1 renal mass [Internet], 2009, http://www.auanet.org/ guidelines/archived-documents (2010, accessed 19 March 2018).
  • 7-European Association of Urology. Guidelines on renal cell carcinoma [Internet]. http://uroweb. org/guideline/renal-cell-carcinoma/?type=archive (2010, accessed 19 March 2018).
  • 8- Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, Scardino PT, Russo P. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol 2006; 7: 735- 740.
  • 9- Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS; Urologic Diseases in America Project. Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer 2008; 112: 511-520.
  • 10- Thompson RH, Siddiqui S, Lohse CM, Leibovich BC, Russo P, Blute ML. Partial versus radical nephrectomy for 4 to 7 cm renal cortical tumors. J Urol 2009; 182: 2601-2606.
  • 11-Chow WH, Devesa SS, Warren JL, Fraumeni JF, Jr. Rising incidence of renal cell cancer in the United States. JAMA : the journal of the American Medical Association. 1999;281(17):1628-31.
  • 12-Aaltomaa S, Lipponen P, Ala-Opas M, Eskelinen M, Syrjanen K. Prognostic value of Ki-67 expression in renal cell carcinomas. European Urology. 1997;31(3):350-5.
  • 13-Furniss D, Harnden P, Ali N, Royston P, Eisen T, Oliver RT, et al. Prognostic factors for renal cell carcinoma. Cancer treatment reviews. 2008;34(5):407-26.
  • 14-Bengió RG, Arribillaga LC, Epelde J, Orellana S, Montedoro A, Bengió VM, et al. Evaluation of microvascular invasion as a prognostic factor in the progression of non-metastatic renal cancer. Central European journal of urology,2018;71(4), 386.
  • 15-Guinan PD, Vogelzang NJ, Fremgen AM, Chmiel JS, Sylvester JL, Sener SF, et al. Renal cell carcinoma: tumor size, stage and survival. Members of the Cancer Incidence and End Results Committee. J Urology. 1995;153(3 Pt 2):901-3.
  • 16-Verhoest G, Avakian R, Bensalah K, Thuret R, Ficarra V, Artibani W, et al. Urinary collecting system invasion is an independent prognostic factor of organ confined renal cell carcinoma. J Urology. 2009;182(3):854- 9.
  • 17-Siddiqui SA, Frank I, Leibovich BC, Cheville JC, Lohse CM, Zincke H, et al. Impact of tumor size on the predictive ability of the pT3a primary tumor classification for renal cell carcinoma. J Urology. 2007;177(1):59-62.
  • 18-Leibovich BC, Blute M, Cheville JC, Lohse CM, Weaver AL, Zincke H. Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. J of Urology. 2004;171(3):1066-70.
  • 19-Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. Solid renal tumors: an analysis of pathological features related to tumor size. J Urology. 2003;170(6 Pt 1):2217-20.
  • 20-Patard JJ, Shvarts O, Lam JS, Pantuck AJ, Kim HL, Ficarra V, et al. Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience. J Urology. 2004;171(6 Pt 1):2181-5.
  • 21-Lau WK, Cheville JC, Blute ML, Weaver AL, Zincke H. Prognostic features of pathologic stage T1 renal cell carcinoma after radical nephrectomy. Urology. 2002;59(4):532-7.
  • 22-Lee LS, Yuen JS, Sim HG. Renal cell carcinoma in young patients is associated with poorer prognosis. Annals of the Academy of Medicine, Singapore. 2011;40(9):401-6.
  • 23-May M, Aziz A, Zigeuner R, Chromecki T, Cindolo L, Schips L, et al. Gender differences in clinicopathological features and survival in surgically treated patients with renal cell carcinoma: an analysis of the multicenter CORONA database. World J urol. 2013.
  • 24-Tsui KH, Shvarts O, Smith RB, Figlin RA, deKernion JB, Belldegrun A. Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria. J Urology. 2000;163(4):1090-5.
  • 25-Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zincke H. An outcome prediction model for patients with clear cell renal cell carcinoma treated with radical nephrectomy based on tumor stage, size, grade and necrosis: the SSIGN score. J Urology. 2002;168(6):2395-400.
  • 26-Patard JJ, Leray E, Rioux-Leclercq N, Cindolo L, Ficarra V, Zisman A, et al. Prognostic value of histologic subtypes in renal cell carcinoma: a multicenter experience. Journal of clinical oncology : official journal of the American Society of Clinical Oncology. 2005;23(12):2763-71.
  • 27-Leibovich BC, Lohse CM, Crispen PL, Boorjian SA, Thompson RH, Blute ML, et al. Histological subtype is an independent predictor of outcome for patients with renal cell carcinoma. J Urology. 2010;183(4):1309-15.
  • 28-Teloken PE, Thompson RH, Tickoo SK, Cronin A, Savage C, Reuter VE, et al. Prognostic impact of histological subtype on surgically treated localized renal cell carcinoma. J Urology. 2009;182(5):2132-6.
There are 28 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Bahri Gök 0000-0002-2295-234X

Kemal Ener This is me

Abdullah Erdem Canda

Ali Fuat Atmaca

Serkan Altınova

Ziya Akbulut

Mevlana Derya Balbay

Publication Date June 28, 2019
Submission Date March 22, 2019
Published in Issue Year 2019 Volume: 9 Issue: 2

Cite

AMA Gök B, Ener K, Canda AE, Atmaca AF, Altınova S, Akbulut Z, Balbay MD. Renal Hücreli Kanser Nedeniyle Radikal Ve Parsiyel Nefrektomi Yapılan Hastaların Onkolojik Sonuçlarının Karşılaştırılması. Sakarya Tıp Dergisi. June 2019;9(2):326-336. doi:10.31832/smj.543504

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