SURGICAL TREATMENT OF LUNG METASTASES OF KIDNEY CANCER
- 作者: Matveev V.B1, Volkov M.I1, Turkin I.N1, Allahverdiyev A.K1, Klimov A.V1
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隶属关系:
- 期: 编号 1 (2013)
- 页面: 63-69
- 栏目: Articles
- URL: https://journals.eco-vector.com/1728-2985/article/view/279684
- ID: 279684
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The medical records of 60 patients who underwent surgery to remove the lung metastases of T1-4N0-2 kidney cancer were retrospectively analyzed. The age of patients ranged from 31 to 70 years. Synchronous lung metastases were diagnosed in 20 (33.3%) cases, metachronous — in 40 (66.7%). 53 (88.3%) patients had lesions in one lung, and 7 (11.7%) patients — in both lungs. Solitary metastases were present in 41 (68.3%) patients, multiple — in 19 (31.7%). In 69.4% of cases, the size of lung metastases was more than 2 cm. Metastasis at other sites at the time of surgery on the lungs were present in 1 patient (supraclavicular lymph nodes). The primary tumor was removed in 56 (93.3%) of 60 patients. All 60 patients underwent removal of lung metastases (radical — 53 [88.3%]). One patient underwent a radical supraclavicular lymph node dissection. All tumor lesions were removed in 50 (83.3%) patients. Median follow-up period was 20 (3-155) months. Perioperative complication rate was 6.6%; no deaths caused by complications of treatment were registered. Histologically, metastases of renal cell carcinoma were verified in all removed lesions from the lungs; 3 (5%) patients had mediastinal lymph node metastases. Five- and 10-year overall, specific and recurrence free survival rates were 36.3 and 19.1%, 38.9% and 27.2, 20.4 and 11.7%, respectively. Univariate analysis demonstrated an adverse effect of pN + category, bilateral pulmonary lesions, the presence of mediastinal lymph nodes metastases and non-radical removal of malignant lesions of the lung on the specific survival. Multivariate analysis confirmed a significant effect of radical surgery on the survival.
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