Bilateral renal cancer
| Autor: | Yu. G. Alyayev, Z. G. Grigoryan |
|---|---|
| Jazyk: | ruština |
| Rok vydání: | 2020 |
| Předmět: | |
| Zdroj: | Onkourologiâ, Vol 4, Iss 3, Pp 16-24 (2020) |
| ISSN: | 1996-1812 1726-9776 |
| Popis: | Among 1430 patients with renal tumors who have been treated and followed up in urologic clinic of I.M. Sechenov Moscow Medical Academy from 1973 to 2006, bilateral tumors were found in 117 (8,2%) of whom in 81 (5,7%) bilateral renal cancer was diagnosed: 51 (3,6%) patients had synchronous and 30 (2,1%) — asynchronous cancers. Bilateral renal cancer is an absolute indication for renal-conserving surgery. Side of initial operation is decided individually taking into consideration clinical manifestations of disease and local tumor characteristics. In case of overt clinical manifestations the side of more extensive disease is selected for first stage surgery. Otherwise, surgical treatment should be started from kidney which is more suitable for organ-conserving surgery: the reference points are size, localization and growth direction of tumor and to lesser extent stage of disease. Analysis of morphologic structure of renal cancer revealed similar patterns of tumors on both sides in 92,5% of patients with synchronous and 85,2% with asynchronous bilateral renal cancer. The same grade of tumor differentiation of cancerous tissue of both sides was found in 72,5% patients with synchronous and 48,1% with asynchronous cancers. Among patients with asynchronous bilateral renal cancer of different grades of differentiation of their tumors, second tumors were of higher grade of malignancy in 92,9% of these patients. Molecular genetics revealed mutations of genes VHL and FHIT of 3rd pair of chromosomes in all patients with bilateral renal cancer. Our data demonstrates that bilateral renal cancer is genetically determined pathology which can manifest itself synchronously or asynchronously, quite often in considerable time interval. Overall and adjusted 5-year survival rates were 62,7% and 68,6% for patients with bilateral synchronous renal cancer and 53,3% and 60,0% for patients with asynchronous cancer. |
| Databáze: | OpenAIRE |
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