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

References

  1. Abou E.l., Fettouh H.I., et al. Sporadic renal cell carcinoma in young adults: presentation, treatment, and outcome. Urology. 2002;60(5): 806-810.
  2. Goetzl M.A. et al. Natural history and clinical outcome of sporadic renal cortical tumors diagnosed in the young adult. Urology. 2004;63(1):41-45.
  3. Eggener S.E. et al. Renal tumors in young adults. J. Urol. 2004;171(1): 106-110.
  4. Aziz A. et al. Do young patients with renal cell carcinoma feature a distinct outcome after surgery? A comparative analysis of patient age based on the multinational CORONA database. J. Urol. 2014;191(2):310-315.
  5. Bausch B. et al. Renal cancer in von Hippel-Lindau disease and related syndromes. Nat Rev Nephrol. 2013;9(9):529-538.
  6. Shuch B. et al. Defining early-onset kidney cancer: implications for germline and somatic mutation testing and clinical management. J. Clin Oncol. 2014;32(5):431-437.
  7. Volpe A. et al. The natural history of incidentally detected small renal masses. Cancer. 2004;100(4):738-745.
  8. Patard J.J. et al. The changing evolution of renal tumours: a single center experience over a two-decade period. Eur Urol. 2004;45(4):490-493; discussion 493-4.
  9. Rendon R.A., Jewett M.A. Expectant management for the treatment of small renal masses. Urol Oncol. 2006;24(1):62-67.
  10. Verhoest G. et al. Relationship between age at diagnosis and clinicopathologic features of renal cell carcinoma. Eur Urol. 2007;51(5) : 1298-1304; discussion 1304-5.
  11. Akhavan A. et al. Renal cell carcinoma in children, adolescents and young adults: a National Cancer Database study. J. Urol. 2015;193(4): 1336-1341.
  12. Hancock S.B., Georgiades C.S. Kidney Cancer. Cancer J. 2016;22(6): 387-392.
  13. Gill I.S. et al. Clinical practice. Small renal mass. N. Engl J. Med. 2010;362(7):624-634.
  14. Hsieh J.J. et al. Renal cell carcinoma. Nat Rev Dis Primers. 2017;3:17009.
  15. Аль-Агбар Н.И. Маленькая опухоль почки. Дисс. д.м.н. М., 2003
  16. Каприн А.Д., А.О.И., Сивков А.В., Анализ уронефрологической заболеваемости и смертности в Российской Федерации за 2003- 2013 гг. Экспериментальная и клиническая урология, 2015;2:4-12
  17. Brunocilla E. et al. Small renal masses initially managed using active surveillance: results from a retrospective study with long-term follow-up. Clin Genitourin Cancer. 2014;12(3):178-181.
  18. Шпоть Е.В. Бессимптомные заболевания почек и верхних мочевых путей. диагностика и лечение. Дисс. д.м.н. М., 2017. 333 с.
  19. Riley B.D. et al. Essential elements of genetic cancer risk assessment, counseling, and testing: updated recommendations of the National Society of Genetic Counselors. J. Genet Couns. 2012;21(2):151-161.
  20. Siemer S. et al. Outcome of renal tumors in young adults. J. Urol. 2006;175(4):1240-1243; discussion 1243-4.
  21. Zhuge Y. et al. Pediatric non-Wilms renal tumors: subtypes, survival, and prognostic indicators. J. Surg Res. 2010;163(2):257-263.
  22. Megison M.L. et al. FAK inhibition abrogates the malignant phenotype in aggressive pediatric renal tumors. Mol Cancer Res. 2014;12(4):514-526.
  23. Trepanier A. et al. Genetic cancer risk assessment and counseling: recommendations of the national society of genetic counselors. J. Genet Couns. 2004;13(2):83-114.
  24. Попов С.В., Гусейнов Р.Г., Борисенков М.Б., Новиков А.И., Скрябин О.Н., Орлов И.Н., Зайцев Э.В., Топузов Т.М., Манихас Г.М., Карлов П.А. Сравнительная оценка выживаемости пациентов с раком почки после эндовидеохирургической радикальной нефрэктомии и резекции почки. Онкоурология. 2013;9(2):21-25

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