Značaj konzervirajućih operacija u lečenju lokalizovanog karcinoma bubrežnog parenhima
The importance of conservative surgery in the treatment of localized renal cell carcinoma
Author
Janičić, AleksandarMentor
Tulić, Cane
Committee members
Džamić, ZoranAćimović, Miodrag
Đokić, Milan
Metadata
Show full item recordAbstract
U ovoj kohortnoj studiji ispitivali smo značaj konzervirajućih operacija u lečenju
lokalizovanog karcinoma bubrežnog parenhima. U našem radu analizirane su: epidemiološke
karakteristike, patoanatomske karakteristike tumora, patohistološke karakteristike, vrste
operativnog lečenja, hirurške komplikacije i preživljavanje bolesnika sa lokalizovanim
karcinomom bubrežnog parenhima. Ova studija sprovedena je na Urološkoj klinici Kliničkog
centra Srbije u periodu 1996-2015.godine. Posebno su analizirani podaci koji su se odnosili
na: godine starosti bolesnika u vreme hirurškog lečenja, pol bolesnika, komorbiditet,
lokalizacija tumora, veličinu tumorske lezije, patohistološki tip. Za analizu podataka
korišćene su metode deskriptivne i analitičke statistike, a za analizu preživljavanja primenjena
je Kaplan-Majerova metoda. Od 204 bolesnika 120 (58,82%) bili su muškarci, a 84 (41,18%)
su bile žene. Prosečna starosna dob bila je 58,808+-12,13 (24-79). Asimptomatska
prezentacija tumora bila je kod... 62,25% bolesnika. Prosečna veličina tumorske lezije iznosila
je 38,64+-8,06 mm, a naveći broj bolesnika imao je tumor veličine 4cm. Kod 115 pacijenata
urađena je konzervirajuća operacija zbog lokalizovanog karcinoma bubrežnog parenhima.
Iz imperativnih indikacija poštedna operacija urađena je kod 32 bolesnika, dok je iz
elektivnih razloga konzervirajuća operacija sprovedena kod 83 bolesnika. U našem
istraživanju 79 bolesnika bilo je sa lokalizovanim karcinomom bubrega veličine do 4cm (T1a
stadijuma) koji su operisani konzervirajućom operacijom u prisustvu normalnog
kontralateralnog bubrega (elektivna indikacija). Kod 89 bolesnika sa lokalizovanim tumorom
T1a stadijuma urađena je radikalna nefrektomija u prisustvu normalnog nalaza na suprotnom
bubregu. Analizom naših rezultata zaključili smo da broj poštednih operacija iz godine u
godinu raste, kao i da je sve veći broj pacijenata koji je lečen konzervirajućom procedurom iz
elektivnih indikacija zbog lokalizovanog karcinoma bubrežnog parenhima. Iz analize
petogodišnjeg preživljavanja Kaplan-Majerovom metodom pokazano je da nema razlike u
preživljavanju između pacijenata kojima je urađena poštedna operacija bubrega i radikalna
nefrektomija zbog tumora bubrega T1a stadijuma.
In this cohort study we examined the importance of conservative surgery in the treatment of
localised renal parenchyma carcinoma. In the course of study we analysed epidemiological
features, pathoanatomic features of the tumour, pathohistological features, types of operative
treatment, surgical complications and survival rate of the patients with localised renal
parenchyma carcinoma. The study was conducted at the Urology Clinic of the Clinical Centre
of Serbia in the period between 1996 and 2015. Data referring to patients’ age at the time of
the surgical treatment, gender, comorbidity, tumour localisation, the size of tumour lesion and
pathohistological type was analysed separately. Methods of descriptive and analytical
statistics were used to analyse the data, and the Kaplan-Majer method was applied to analyse
the survival rate. Out of 204 patients, 120 (58.82%) were male, and 84 (41.18%) were
women. The average age of the patients was 58,808 +-12.13 (24-79). With 62.25% of the
pati...ents tumours presented asymptomatically. The average size of tumour lesion was 38.64+-
8.06mm, and the largest number of patients had 4cm tumours. 115 patients underwent
conservative surgery because of the localised renal parenchyma carcinoma. Conservative
surgery due to imperative indications was performed on 32 patients, whereas 83 patients
underwent conservative surgery due to elective reasons. In our study, 79 patients had
localised renal carcinomas up to 4cm in size (T1a stage), which were removed by
conservative surgery in the presence of a normal contralateral kidney (elective indication).
89 patients with localised T1a stage tumours underwent a radical nephrectomy in the
presence of normal contralateral kidney findings. After analysing our results, we concluded
that the number of conservative surgeries has been growing over the years, and that there was
an increasing number of patients treated for the localised renal parenchyma carcinoma by
conservative procedures due to elective indications. The analysis of five-year survival rate
has shown that there is no difference in survival rates between the patients who had
conservative renal surgery and those who had radical nephrectomy due to T1a stage renal
tumour.