电邮这篇文章 Surgical treatment of locally advanced kidney cancer in the T3a–с stage
- 作者: Komyakov B.K.1, Salsanov A.T.1, Matveev V.B.2, Zubarev V.A.1
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隶属关系:
- North-Western State Medical University named after I.I. Mechnikov
- N.N. Blokhin National Medical Research Center of Oncology
- 期: 卷 14, 编号 3 (2024)
- 页面: 247-254
- 栏目: Original articles
- URL: https://bakhtiniada.ru/uroved/article/view/277108
- DOI: https://doi.org/10.17816/uroved634751
- ID: 277108
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详细
BACKGROUND: Kidney cancer is a common pathologic condition, which ranks the 3rd place among urologic cancers. In 4–10% of patients, while growing it metastasizes upward the venous vessels up to the thoracic vena cava and right atrium. Selection of the optimal tactics for surgical treatment of such patients still remains a complex and unsolved task.
AIM: To assess the surgical treatment findings for the patients suffered from kidney cancer with tumor invasion in the renal and inferior vena cava.
MATERIALS AND METHODS: 115 patients with renal cell carcinoma complicated by tumor invasion into renal and inferior vena cava have been operated in North-Western State Medical University named after I.I. Mechnikov from 2003 to 2023. They were 76 (66.1%) men and 39 (33.9%) women, their mean age was 67.0 ± 4.1. Stage T3a covered 53 (46.1%), T3b — 33 (28.7%) and T3c 29 (25.2%) patients. Metastatic lesion of one lymph node was observed in 21 (18.3%) and of multiple nodes in 6 (5.2%) patients. Distant metastases were found in 26 (22.6%) patients: in the lungs in 9.6% and in the adrenal glands in 5.2%. All patients were treated with radical nephrectomy, removing blood trombi from the inferior vena cava system. Eight (7.0%) of them, received the treatment by the method developed in the clinic, which consists in preliminary endovascular extraction of the cranial trombus part. Another 3 (2.6%) patients were treated using cardiopulmonary bypass machine.
RESULTS: Early postoperative complications developed in 36 (31.4%) patients. The most common and severe of them were pulmonary embolism (4.4%) and acute cardiovascular insufficiency (10.4%). These complications appeared the causes of death of 4 patients. The mortality rate was 3.5%. The three year survival rate in the T3a group was 70.6%, T3b group — 66.0% and T3c group — 50.6% (p < 0.05).
CONCLUSIONS: Nephrectomy with vena cava thrombectomy is a radical surgical treatment. Its complexity increases as the tumor thrombus spreads further through the venous system and in some cases requires an interdisciplinary approach.
作者简介
Boris Komyakov
North-Western State Medical University named after I.I. Mechnikov
编辑信件的主要联系方式.
Email: komyakovbk@mail.ru
ORCID iD: 0000-0002-8606-9791
SPIN 代码: 7864-9123
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, Saint PetersburgArtem Salsanov
North-Western State Medical University named after I.I. Mechnikov
Email: omega06@inbox.ru
SPIN 代码: 2178-3910
俄罗斯联邦, Saint Petersburg
Vsevolod Matveev
N.N. Blokhin National Medical Research Center of Oncology
Email: Vsevolodmatveev@mail.ru
ORCID iD: 0000-0001-7748-9527
SPIN 代码: 1741-9963
MD, Dr. Sci. (Medicine), Professor, Corresponding Member of the Russian Academy of Sciences
俄罗斯联邦, MoscowVadim Zubarev
North-Western State Medical University named after I.I. Mechnikov
Email: vadim_zubarev@mail.ru
ORCID iD: 0009-0006-5265-3830
SPIN 代码: 6664-7589
MD, Cand. Sci. (Medicine), Associate Professor
俄罗斯联邦, Saint Petersburg参考
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