Оперативное лечение двустороннего почечно-клеточного рака

Аннотация

The paper presents the results of surgical treatment of bilateral tumors of the kidneys. Bilateral neoplasms were detected in 28 of 1200 patients with renal cell carcinoma (2.3%). Synchronous tumors were found in 12 patients (42.8%), asynchronous - in 16 (57.2%). Operation on both the kidneys for tumor was carried out in 21 patients from 28 (75%). In both groups operations including enucleation of the tumors (60% in the group with synchronous cancer and 53.8%) in the group with asynchronous one) prevailed. All the patients were operated in two stages. Local relapses occurred in 6 of 21 patients (28.5%). A relapse after nephrectomy was observed in 2 patients (9.5%). Recurrent tumor in the remnant of the kidney after nephron-sparing surgery was observed in 4 patients (19%). General 5 year survival in patients with synchronous bilateral tumors was 38.5%, whereas 5-year cancer-specific survival reached 47.4%. For asychronous cancer these parameters were 49.6 and 58.7%, respectively. It is emphasized that all patients with renal cancer after radical nephrectomy should be followed up and undergo annual check-up with US and/or CT lifelong to detect possible asynchronous tumor. Genetic studies are necessary to specify differentiation of the form of bilateral neoplasm.