Lokal ve lokal ileri evre Renal hücreli karsinomalarda cerrahi yaklaşım ve uzun dönem takip sonuçları: Tek merkez deneyimi
Öz
Amaç: Lokal ve lokal ileri evre renal hücreli kanserde altın standart tedavi cerrahidir. Cerrahi tedaviler parsiyel nefrektomi ve radikal nefrektomi olarak ayrılırken yöntem olarak ise açık, laparoskopik ve robotik yöntemler mevcuttur.Bu çalışmamızda lokal ve lokal ileri evre renal hücreli karsinomda cerrahi yaklaşımımızı ve uzun dönem takip sonuçlarımızı değerlendirmeyi amaçladık.
Gereç Ve Yöntem:
Çalışmaya Ocak 2011 ve şubat 2019 tarihleri arasında renal kitle nedeniyle cerrahi tedavi uygulanıp patoloji sonucu renal hücreli karsinom olarak raporlanan 119 hasta dahil edildi. Elde edilen veriler doğrultusunda hastalar retrospektif olarak incelendi.
Bulgular:
Çalışmaya dahil edilen 119 hastanın 76’sına radikal nefrektomi, 43’üne parsiyel nefrektomi yapıldı.82 hastanın patoloji sonucu berrak hücreli karsinom iken 21 hastanın papiller hücreli tip, 11 hastanın ise kromofob hücreli karsinom olduğu görüldü.En sık izlenen T evresi 33 hasta ise T2b olduğu görülürken en sık izlenen fuhrman derecesinin 48 hasta ile fuhrman derece 1 olduğu görüldü.
Sonuç: Lokal ve lokal ileri evre Renal hücreli karsinom tedavisinde cerrahi en etkin ve güvenilir yöntemdir.
Anahtar Kelimeler: Böbrek tümörü, nefrektomi, sonuçlar
Anahtar Kelimeler
Kaynakça
- Beasley KA, Al Omar M, Bochinski SAD, Khakhar A, Izawa JI et al. (2004). Laparoscopic versus open partial nephrectomy. Urology. 64(3), 458-461.
- Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, et al. (1991) Laparoscopic nephrectomy: initial case report. Journal of Urology.146(2), 278-282.
- Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Michael D Darcy MD et al. (2017). Laparoscopic Nephrectomy: Initial Case Report. Jouunal of Urology. 197(2), 182-186.
- Cohen HT, McGovern FJ. Renal-cell carcinoma. (2005). The New England Journal of Medicine. 353(23), 2477-2490.
- Fergany AF, Hafez KS, Novick AC. (2000). Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. The Journal of urology. 163(2), 442-445.
- Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zinckeet H. (2002). 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. The Journal of urology. 168(6), 2395-2400.
- Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun M.J. (2007). Cancer statistics, CA: A Cancer Journal for Clinicians. 57(1), 43-66
- Kazan D, Gemalmaz H. (2013). Böbrek kanserinde küratif tedavi sonrası izlem prensipleri. Üroonkoloji Bülteni.12(3),194-200.
- Kovacs G, Akhtar M, Beckwith BJ, Bugert P, Cooper CS, Delahun B et al. (1997). The Heidelberg classification of renal cell tumours. Journal of Pathology. 183(2), 131-133.
- Kural AR, Demirkesen O, Onal B, Obek C, Tunc B, Ali Ulvi Onder AU et al. (2003). Outcome of nephron-sparing surgery: elective versus imperative indications. Urologia Internationalis. 71(2),190-196.
- Lam JS, Klatte T, Kim HL, Patard JJ, Breda A, Zisman A, et al. (2008). Prognostic factors and selection for clinical studies of patients with kidney cancer. Critical reviews in oncology/hematology. 65(3), 235-262.
- Larroquette M, Peyraud F, Domblides C, Lefort F, Bernhard JC, Ravaud A, et al. (2021). Adjuvant therapy in renal cell carcinoma: Current knowledges and future perspectives. Cancer Treatment Reviews 97(5), 102207.
- Luo J-H, Zhou F-J, Xie D, Zhang Z-L, Liao B, Zhao H-W, et al. (2010). Analysis of long-term survival in patients with localized renal cell carcinoma: laparoscopic versus open radical nephrectomy. World journal of urology. 28(3),289-293.
- MacLennan S, Imamura M, Lapitan MC, Omar MI. (2012). Lam TBL 3, Ana M Hilvano-Cabungcal AMH et al. Systematic review of oncological outcomes following surgical management of localised renal cancer. Eurpean Urology. 61(5). 972-993
- Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS. (2008). Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 112(3), 511-520.
- Park H, Byun SS, Kim HH, Lee SB, Kwon TG, Jeonet SH al. (2010). Comparison of laparoscopic and open partial nephrectomies in t1a renal cell carcinoma: a korean multicenter experience. Korean Journal of Urology. 51(7), 467-467
- Robson CJ. (1963). Radical nephrectomy for renal cell carcinoma. Journal of Urology. 89, 37-42. Robson CJ, Churchill BM, Anderson W. (1969). The results of radical nephrectomy for renal cell carcinoma. Journal of Urology. 101(3), 297-301.
- Springer C, Hoda MR, Fajkovic H, Pini G, Mohammed N, Fornara P, et al. (2013). Laparoscopic vs open partial nephrectomy for T1 renal tumours: evaluation of long-term oncological and functional outcomes in 340 patients. British journal of urology international. 111(2), 281-288.
- Stewart GD, Klatte T, Cosmai L, Bex A, Lamb BW, Moch H, et al. (2022) The multispeciality approach to the management of localised kidney cancer. Lancet 13;400(10351):523-534.
- Sun M, Lughezzani G, Jeldres C, Isbarn H, Shariat SF, Arjane P, et al. (2009). A proposal for reclassification of the Fuhrman grading system in patients with clear cell renal cell carcinoma. European urology. 56(5), 775-781.
- Thompson RH, Boorjian SA, Lohse CM, Leibovich BC, Kwon ED, Chevilleet JC al. (2008). Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. Journal of Urology. 179(2),468-471
- Winfield HN, Donovan JF, Godet AS, Clayman RV. (1993). Laparoscopic partial nephrectomy: initial case report for benign disease. Journal of Endourology. 7(6), 521-526.
- Woodruff DY, Van Veldhuizen P, Muehlebach G, Johnson P, Williamson T, Holzbeierlein JM . (2013). The perioperative management of an inferior vena caval tumor thrombus in patients with renal cell carcinoma. Urology Oncology. 31(5), 517-521.
Surgical Approach and Long-Term Follow-Up Results in Locally And Locally Advanced Renal Cell Carcinomas: A Single Center Experience
Öz
Objective: Surgery is the gold standard treatment for locally and locally advanced renal cell cancer. However, data on long-term outcomes are limited. In this study, it was aimed to evaluate the surgical approach and long-term follow-up results in local and locally advanced renal cell carcinoma.
Material and Method: 119 patients were included in this study who underwent surgical treatment for renal mass between January 2011 and February 2019 and were reported as renal cell carcinoma. Patients were analyzed retrospectively according to the data obtained. All patients were evaluated with contrast-enhanced computed tomography and/or magnetic resonance imaging preoperatively. Age, gender, tumor localization, tumor size, pathology result, blood transfusion, operation time, hospital stay, perioperative and postoperative complications of all patients were recorded.
Results: Of the 119 patients who were included in the study, 76 underwent radical nephrectomy and 43 underwent partial nephrectomy. Radical nephrectomy was performed in 76 (63.9%) and partial nephrectomy in 43 (36.1%) of 119 patients included in the study. The pathology results of 82 patients were clear cell carcinoma, 21 patients were papillary cell carcinoma and 11 patients were chromophobe cell carcinomas. Patients who underwent open radical nephrectomy had a significantly longer hospital stay compared to laparoscopic radical nephrectomy. Warm ischemia time was found to be significantly higher in patients who underwent laparoscopic partial nephrectomy (p<0.025).
Conclusion: Surgery is the most effective and reliable method in the treatment of locally and locally advanced renal cell carcinoma. Laparoscopic radical nephrectomy was found to be superior to open radical nephrectomy, especially with a shorter hospital stay. Long warm ischemia time in laparoscopic partial nephrectomy can be considered as a disadvantage compared to open partial nephrectomy.
Anahtar Kelimeler
Kaynakça
- Beasley KA, Al Omar M, Bochinski SAD, Khakhar A, Izawa JI et al. (2004). Laparoscopic versus open partial nephrectomy. Urology. 64(3), 458-461.
- Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Darcy MD, et al. (1991) Laparoscopic nephrectomy: initial case report. Journal of Urology.146(2), 278-282.
- Clayman RV, Kavoussi LR, Soper NJ, Dierks SM, Meretyk S, Michael D Darcy MD et al. (2017). Laparoscopic Nephrectomy: Initial Case Report. Jouunal of Urology. 197(2), 182-186.
- Cohen HT, McGovern FJ. Renal-cell carcinoma. (2005). The New England Journal of Medicine. 353(23), 2477-2490.
- Fergany AF, Hafez KS, Novick AC. (2000). Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup. The Journal of urology. 163(2), 442-445.
- Frank I, Blute ML, Cheville JC, Lohse CM, Weaver AL, Zinckeet H. (2002). 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. The Journal of urology. 168(6), 2395-2400.
- Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun M.J. (2007). Cancer statistics, CA: A Cancer Journal for Clinicians. 57(1), 43-66
- Kazan D, Gemalmaz H. (2013). Böbrek kanserinde küratif tedavi sonrası izlem prensipleri. Üroonkoloji Bülteni.12(3),194-200.
- Kovacs G, Akhtar M, Beckwith BJ, Bugert P, Cooper CS, Delahun B et al. (1997). The Heidelberg classification of renal cell tumours. Journal of Pathology. 183(2), 131-133.
- Kural AR, Demirkesen O, Onal B, Obek C, Tunc B, Ali Ulvi Onder AU et al. (2003). Outcome of nephron-sparing surgery: elective versus imperative indications. Urologia Internationalis. 71(2),190-196.
- Lam JS, Klatte T, Kim HL, Patard JJ, Breda A, Zisman A, et al. (2008). Prognostic factors and selection for clinical studies of patients with kidney cancer. Critical reviews in oncology/hematology. 65(3), 235-262.
- Larroquette M, Peyraud F, Domblides C, Lefort F, Bernhard JC, Ravaud A, et al. (2021). Adjuvant therapy in renal cell carcinoma: Current knowledges and future perspectives. Cancer Treatment Reviews 97(5), 102207.
- Luo J-H, Zhou F-J, Xie D, Zhang Z-L, Liao B, Zhao H-W, et al. (2010). Analysis of long-term survival in patients with localized renal cell carcinoma: laparoscopic versus open radical nephrectomy. World journal of urology. 28(3),289-293.
- MacLennan S, Imamura M, Lapitan MC, Omar MI. (2012). Lam TBL 3, Ana M Hilvano-Cabungcal AMH et al. Systematic review of oncological outcomes following surgical management of localised renal cancer. Eurpean Urology. 61(5). 972-993
- Miller DC, Schonlau M, Litwin MS, Lai J, Saigal CS. (2008). Renal and cardiovascular morbidity after partial or radical nephrectomy. Cancer. 112(3), 511-520.
- Park H, Byun SS, Kim HH, Lee SB, Kwon TG, Jeonet SH al. (2010). Comparison of laparoscopic and open partial nephrectomies in t1a renal cell carcinoma: a korean multicenter experience. Korean Journal of Urology. 51(7), 467-467
- Robson CJ. (1963). Radical nephrectomy for renal cell carcinoma. Journal of Urology. 89, 37-42. Robson CJ, Churchill BM, Anderson W. (1969). The results of radical nephrectomy for renal cell carcinoma. Journal of Urology. 101(3), 297-301.
- Springer C, Hoda MR, Fajkovic H, Pini G, Mohammed N, Fornara P, et al. (2013). Laparoscopic vs open partial nephrectomy for T1 renal tumours: evaluation of long-term oncological and functional outcomes in 340 patients. British journal of urology international. 111(2), 281-288.
- Stewart GD, Klatte T, Cosmai L, Bex A, Lamb BW, Moch H, et al. (2022) The multispeciality approach to the management of localised kidney cancer. Lancet 13;400(10351):523-534.
- Sun M, Lughezzani G, Jeldres C, Isbarn H, Shariat SF, Arjane P, et al. (2009). A proposal for reclassification of the Fuhrman grading system in patients with clear cell renal cell carcinoma. European urology. 56(5), 775-781.
- Thompson RH, Boorjian SA, Lohse CM, Leibovich BC, Kwon ED, Chevilleet JC al. (2008). Radical nephrectomy for pT1a renal masses may be associated with decreased overall survival compared with partial nephrectomy. Journal of Urology. 179(2),468-471
- Winfield HN, Donovan JF, Godet AS, Clayman RV. (1993). Laparoscopic partial nephrectomy: initial case report for benign disease. Journal of Endourology. 7(6), 521-526.
- Woodruff DY, Van Veldhuizen P, Muehlebach G, Johnson P, Williamson T, Holzbeierlein JM . (2013). The perioperative management of an inferior vena caval tumor thrombus in patients with renal cell carcinoma. Urology Oncology. 31(5), 517-521.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Tıp Bilimleri |
| Bölüm | Orijinal Araştırma Makaleleri |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2023 |
| Gönderilme Tarihi | 28 Aralık 2022 |
| Yayımlandığı Sayı | Yıl 2023 Cilt: 16 Sayı: 1 |
Van Health Sciences Journal (Van Sağlık Bilimleri Dergisi) başlıklı eser bu Creative Commons Atıf-Gayri Ticari 4.0 Uluslararası Lisansı ile lisanslanmıştır.
