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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