PTU - Polskie Towarzystwo Urologiczne
list of articles:

The comparison of radical versus kidney sparing surgery for renal cancer stage T1;, N0 M„. The prospective randomised clinical trial
Article published in Urologia Polska 2001/54/1.

authors

Andrzej Stokłosa, Maciej Czaplicki, Andrzej Borkowski
Katedra i Klinika Urologii Akademii Medycznej w Warszawie Kierownik Kliniki: prof, drhab. med. Andrzej Borkowski

keywords

kidney, renal carcinoma, radical nephrectomy, kidney sparing surgery

summary

The main aim of the study is to assess the curative affect of a partial resection in patients with a single, low stage, non-metastatic, well localized and well delineated renal carcinoma.
Material and methods. After randomisation of 22 patients 11 have been assigned to the group of radical nephrectomy and 11 to the group of conservative surgery.
Criteria for inclusion. Solitary T.-T, renal tumours in the presence of a normal contralateral kidney, the tumour must be well located so thai surgery can be done safely in healthy tissue, the size of the tumour should not exceed 5 cm in diameter and must be single on usg and CT scan, NC| MCJ, the patient must be fit for surgery and the informed consent is obligatory. The surgery consisted of the radical nephrectomy or of the tumour excision (not enucleation). The limited lymphadenectomy was mandatory in both of above described methods of the treatment.
The results. In 9/11 patients of radical nephrectomy group histopafhology showed clear cell carcinoma and in 2 patients oncocytoma. In 9/11 patients of conservative surgery group histopafhology revealed clear cell carcinoma, 1 patient had oncocytoma and 1 had papillary adenoma. None of 22 patients had metastases in hilar lymph nodes. During follow-up all 22 patients remained free from distant metastases. One patient from conservative surgery group developed local recurrence within 1 year post surgery, and I showed atrophy of the operated kidney within 7 month after excision of the tumour.
Conclusion. We conclude that conservati vc surgery seems to be sufficient treatment for patients with single, low-stage, less than 5 cm in diameter, well located renal carcinoma.

references

  1. [I] Adadyiiski L., Fiedor P.. Malewski A., Czaplicki M, Borkowski A., Wałaszewski J.: Zastosowanie kontaktowego koagulalora foto nowego podczas częściowego wycięcia nerki. Zarys klinicznych zastosowań laserów. P. Fiedor. T. Kccik i wsp. (red.). Dom Wydawni-czyAnkar, warszawa 1995,389-393.
  2. /2/ Butler B., Novick A.. Miller D., Campbell S.. Licht M.: Management of small unilateral renal cell carcinomas: radical versus nephron-sparingsurgery. Urology 1995,45,34-37.
  3. [3J Campbell S., Kichtncr J.. Novick A., Sleinbach P;., Stockle M.. Klein E., FilipasR-. Levin II., Slorkcl S., Schweden F.,Obuchow-ski N., Hale J..- Intraoperative evaluation of renal cell carcinoma: a prospective study of the role of ultrasonography and histopatologicalfrozen sections. J. Urol. 1996, 155,1191-1195.
  4. [4] Cheng W., Farrow 0.. Zinke H..\\\" The incidence of multicentricity in renal cell carcinoma. J. Urol. 1991. 146,1221-1223.
  5. [5] Eschwege P., Sanssine C, Stcichcn G., Delepaul B., Drelon L..Ja-cqmin D.: Radical nephrectomy for renal cell carcinoma JO mm or less: long-term follow-up results.). Urol. 1996. 155,1196-1199.
  6. [6] Fryczkowski M., Paradysz A., Wielicki 7..: Wyniki leczenia raka jasnokomórkowego nerek za pomocą operacji organooszczę-dzającyck Uroi. Pol. 1990,43,163-169.
  7. [7] Jacqmin.D., Saussine C. Roca D.. Roy C. Bollack C\\\' Multiple tumors in the same kidney: incidence and therapeutic implications. Eur. Urol. 1992.21.32-34.
  8. [8 JLicht VI., Novick A., Goonuastic M.: Nephron sparing surgery in incidental versus suspected renal cell carcinoma. J.Urol. 1994,152,39-42.
  9. [9] I .iclit M.. Novick A.: Nephron sparing surgery for renal cell carcinoma. J. Urol. 1992.149.1-7.
  10. [10] Musierowicz A.. I.abedzki A,. Bianias B.. Kubicz Z.: Wylusz-czenie guza i częściowe wycięcie nerki w leczeniu nowotworów złośliwych nerki. Uroi. Pol. 1995, 48, 199-202.
  11. [II JMusicrowicz A.. Molenda W.. Łabędzki A., Magusiak B., Kubicz Z.: Przypadek wyluszczenia raka jasnokomórkowego jedynej nerki, w której przed 8 laty wytworzono przetokę kołową. Uroi. Pol. 1995, 48, 240-242.
  12. [12] Robson C, Churchill B., Andersen W.: The results of radical nephrectomy for renal cell carcinoma. J. Urol. 1969, 101, 297-301.
  13. [13] Skinner D.: Editorial Comment: Conservative surgical treatment of renal cell carcinoma. J. Urol. 1989, 140,730-731.
  14. [14] Sleibach F.. Slockle M., Muller J., Thuroff S., MelchiorS.. Stein R.. Hohenfellner, R.: Conservative surgery of renal cell tumors in 140palients: 21 years experience. J. Urol. 1992. 148.24-30.
  15. /15/ Velagapudi S.. Ruckle H.. Zinkc H.: Conservative surgery (CS) in patients with unilateral renal cell cancer (RCC) and a normal contralateral unit; experience with 60 patients. .1. Urol. 1993, part 2. 149. 446A, abstract 935.

correspondence

Andrzej Stokłosa
Katedra i Klinika AM
ul. Lindley \\\'a 4, 02-005 Warszawa