PTU - Polskie Towarzystwo Urologiczne
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Probability of renewal and distant metastases in B and C stadium according to Robson in patients suffering from renal cell carcinoma, treated with nephrectomy and irradiation
Article published in Urologia Polska 2002/55/3.


Małgorzata Zarzycka 1, Zbigniew Wolski 2, Wiesława Windorbska 1, Andrzej Lebioda 3
1 Regionalne Centrum Onkologii w Bydgoszczy, Oddział i Zakład Teleradioterapii
Kierownik zakładu: dr Wiesława Windorbska
2 Klinika Urologii Akademii Medycznej im. L. Rydygiera w Bydgoszczy
Kierownik kliniki: prof, dr hab. Zbigniew Wolski
3 Katedra i Zakład Onkologii Akademii Medycznej w Bydgoszczy
Kierownik katedry: dr hab. Roman Makarewicz


kidney, renal cell carcinoma, radiotherapy, late recurrence, distant metastases


Objective. A retrospective analysis of 251 patients, with advanced renal cell carcinoma from 1985-1998, is presented.
Purpose. The aim of this study was to assess the influence of postoperative radiotherapy on local recurrence and distant metastases rates.
Materials and methods. The medical records of 148 patients with stage B and 103 patients with stage C treated according to the Robson system were reviewed. Postoperative radiotherapy with megavoltage was given to 136 patients - group 11-R[+],
A control group I-R[-] - underwent nephrectomy, but did not receive radiation therapy. This group consisted of 115 patients, who had indications to postoperative radiotherapy. Differences between the groups were evaluated by Student s-tesl or test U, respectively. Actuarial Curves for local recurrence and distant metastases rates, were calculated using the Kaplan-Meier method. Survival curves were compared using the log rank test. Results. Thirty patients (11,95%) had local recurrence. The local failure rate and lime when the failure appeared was comparable in both groups in stage B and C according to the Robson system. The observed difference was not statistically significant (p>0,05). The 5 years actuarial local relapse rates in stage B was 19% for group R[-] and 4% for group R[+J. The difference in both groups was statistically significant (p=0,032). There was no statistical difference in stage C (p>0,05). Seventy seven (30,7%) patients had distant metastases. The difference in rates and time when the failure appeared in both groups in stage B and C according to the Robson system was not statistically significant (p>0,05). The 5 years actuarial distant metastases rates in stage B was 38% for group Rf-J and 20% for group R[+J. The difference in both groups was statistically significant (p=0,014). There was no statistical difference in stage C (p>0,05). Conclusion. Postoperative radiotherapy decrease the probability of local recurrences and distant metastases within 5 years in patients with stage B according to the Robson system with renal cell carcinoma after nephrectomy.


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Malgor+ata Zarzycka
Regionalne Centrum Onkologii Oddziału Radoterapii
ul. t Romanowskiej 2
85-794 Bydgoszcz