Abstract
Renal cell carcinoma (RCC) accounts for 90-95% of all neoplastic lesions of the kidney. In Russia in 2008 defined 17 563 new cases of RCC. In this common tumor found in 45.6 % of cases. A metastatic forms are still a significant part of RCC – 28-32%. In the last decade the proportion of localized tumors increased to 55.4% and the 5-year cancer survival for local forms of RCC is 86-98%. However, it is not accompanied by a significant increase in overall survival. This situation is definitely needed in the analysis. First of all, to assess the impact of surgical treatment on survival . Radical nephrectomy remains the gold standard for surgical treatment of RCC, including the treatment of small tumors and produced more than 80% of cases. Assessing the impact of surgery on renal function is necessary also due to the fact that in 26% of patients with localized tumors , the opposite kidney healthy and normal preoperative serum creatinine glomerular filtration rate (GFR ) less than 60 ml/min . Even at baseline GFR from 60 to 90 ml/min, patients subjected to radical nephrectomy have 58% risk reduction of its <60 ml/min. In this group of patients in the 2-fold increased risk of cardiovascular complications and 4.5 times the risk of death. Within three years after radical nephrectomy in 21.6% of patients have progression of cardiovascular disease and 6.0% of patients die from complications associated with them.
Highlights
Кафедра урологии и репродуктивного здоровья человека с курсом детской урологии-андрологии ГБОУ ВПО РостГМУ Минздрава России, г.Ростов-на-Дону
In the last decade the proportion of localized tumors increased to 55.4% and the 5-year cancer survival for local forms of Renal cell carcinoma (RCC) is 86-98%
Radical nephrectomy remains the gold standard for surgical treatment of RCC, including the treatment of small tumors and produced more than 80% of cases
Summary
Почечно-клеточный рак (ПКР) составляет 90-95% всех опухолевых поражений почки. В последнее десятилетие доля локализованных опухолей увеличилась до 55,4% и 5-летняя канцерспецифическая выживаемость при локальных формах ПКР составляет 86-98%. В оценке влияния хирургического лечения на выживаемость пациентов. Радикальная нефрэктомия попрежнему остается золотым стандартом хирургического лечения ПКР, в том числе при лечении малых опухолей и производится более, чем в 80% случаев. Оценка влияния хирургии на почечную функцию необходима еще в связи с тем, что у 26% пациентов с локальными опухолями, здоровой противоположной почкой и нормальным предоперационным уровнем креатинина скорость клубочковой фильтрации (СКФ) меньше 60 мл/мин. В течение трех лет после радикальной нефрэктомии у 21,6% пациентов отмечается прогрессия сердечнососудистых заболеваний и 6,0% больных умирает от осложнений, связанных с ними. Ключевые слова: почечно-клеточный рак, радикальная нефрэктомия, резекция почки, скорость клубочковой фильтрации
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