The morphologic results of organ-sparing interventions in patients with renal tumor aged up to 40 years and older


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Abstract

Aim: to evaluate the features pathologic results of organ-sparing interventions in patients aged up to 40 years and older and assess an influence of patient age on the recurrence-free survival in case of pathologically proven renal cell cancer. Materials and methods. A retrospective analysis of laparoscopic organsparing removal of kidney tumors in 314 patients performed from January 2012 to May 2017 was conducted. The mean patient age was 54.4±10.9 (25- 78) years. There were 178 males (56.7%) and 136 females (43.3%). All patients were divided into two groups. In Group 1 a total of 37 patients aged ≤ 40 years (11.8%) were included and Group 2 consisted of 277 patients (88.2%) over 40 years. In Group 1 there was no family cases of renal cell cancer. Results. In Group 1 malignant tumors were more common (n=33 cases (89.2%)), and benign tumors were diagnosed in 4 (9.8%) cases. Among patients older than 40 years the malignant and benign tumors were determined in 242 cases (87.4%) and 35 cases (12.6%), respectively. It was estimated that there were no differences in neither malignant tumors rate (p=0.75), nor in proportion of different pathologic forms of benign (p=0.68) and malignant neoplasms (p=0.25), nor in proportion of various degrees of anaplasia (p=0.33). A mortality rate was 0.6% (2 patients in Group 2), and there was 3 relapse (1.1%). A proportion of censored cases was 99.4% for overall survival and 98.9% for recurrence-free survival. A point estimate of overall survival after 36-months follow-up was 35.77±0.16 months. The mean disease-free survival was 35.47±0.24 months. The survival differences between two groups were not significant due to absence of relapse and mortality in patients aged ≤ 40 years. Conclusion. During the planning of surgical treatment of patients with kidney tumors aged ≤ 40 years a preference to organ-sparing interventions should be given. The postoperative genetic counselling is recommended to exclude hereditary renal cell cancer. Considering a high risk of local recurrence in all patients aged < 40 years meticulous and regular follow-up is needed.

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About the authors

Yu. G Alyaev

FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: ugalyaev@mail.ru
corresponding member of RAS, Dr.Med.Sci., professor, Department of Urology

E. S Syrota

FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: essirota@mail.ru
Ph.D., senior researcher at the Scientific Research Institute of Uronephrology and Reproductive Health; Head of Surgical Unit of Urologic clinic

E. A Bezrukov

FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: eabezrukov@rambler.ru
Dr.Med.Sci., professor, Head of Urologic Department №1 of Urologic clinic

Y. V Lerner

FGAOU VO of I.M. Sechenov First Moscow State Medical University of Minzdrav of Russia (Sechenov University)

Email: julijalerner@inbox.ru
assistant at the Department of Pathologic anatomy, pathologist at the Department of Pathology

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