Impact of neoadjuvant targeted therapy on perioperative complications in patients with localized reno-cellular cancer

Abstract

Objective. To study the efficacy of neoadjuvant targeted therapy in treatment of localized reno-cellular cancer and to determine its impact on the perioperative complications rate.
 Materials and methods. There are presented the results of randomized investigation, conducted in 152 patients with localized reno-cellular cancer. Into the main group 75 (49.3%) patients were included, to whom neoadjuvant targeted therapy and operative treatment were conducted, and into the control group - 77 (50.7%) patients, to whom operative treatment was performed only. The groups were randomized in accordance to the main clinical parameters. Efficacy of treatment was estimated in accordance to RECIST 1.1 scale, complications – in accordance to Clavien-Dindo classification.
 Results. Neoadjuvant targeted therapy did not influence the operation duration: (95 ± 19) min – while conduction of targeted therapy and (108 ± 53) min – without conduction of targeted therapy, and duration of postoperative treatment: (5.6 ± 1.9) and (5.2 ± 2.3) bed-days, accordingly. The intraoperative blood loss volume in renal resection of the patients’ main group in comparison with patients of a control group have constituted (407 ± 224) and (317 ± 210) ml accordingly (p=0.013). Neoadjuvant targeted therapy did not influence the perioperative complications rate, which have occurred in 7 (9.3%) patients of the main and in 8 (10.7%) patients of a control group, and their severity did not exceed 3 degrees in accordance to Clavien-Dindo classification.
 Conclusion. Neoadjuvant targeted therapy do not increase the operation duration, the perioperative complications rate and postoperative treatment time, but increases the blood loss volume while performance of renal resection (p=0.013).