Treatment tactics for patients with combined kidney tumor and urolithiasis (clinical cases)

Abstract

Annotation. Global medical literature shows an ever-increasing number of patients suffering from urolithiasis and malignant kidney tumors. The number of patients suffering from both conditions also seems to be on the rise. Correlation and interdependence, as well as the preferable course of treatment for these diseases, remain uncertain. The present study aims to map out treatment strategies for patients presenting with both urolithiasis and kidney tumor. In 2013- 2021 21 patients with urolithiasis and kidney tumor were examined and treated in the SI “Acad. O.F. Vozianov Institute of Urology NAMS of Ukraine”. In 61.9% of cases a tumor and calculi were located unilaterally, in 14.3% contralaterally, and in other 14.3% tumor was comorbid with bilateral urolithiasis. 4.75% of patients had a tumor combined with a stone in the upper third of the ureter on the same side, and 4.75% – in the lower third of the ureter on the opposite side. Depending on the localization of a tumor and a stone, the stage of the oncological process, the presence of metastases, clinical manifestations, etc, different treatment tactics have been employed. Simultaneous removal of a kidney tumor and a stone in case of their ipsilateral location was performed in 52.4% of patients. We prioritized organ-sparing surgery in all cases. 9.52% of patients underwent PNLT before the tumor removal. In 9.52% of patients ureterolith removal was followed by kidney tumor removal. 71.4% of patients underwent successful laparoscopic resection of a tumorous kidney, but in 28.6% of patients, attempts to save the organ failed. So, types of combinations of urolithiasis and kidney tumor can be different, hence, it is necessary to apply individual treatment tactics in each case. If the functional state of a tumorous kidney and technical capacity allow it, organ-sparing surgery is highly advisable.