Influence of tumor size on NSS distant results and progression in patients with pT1 renal tumors
Article published in Urologia Polska 2008/61/Supl. 1.

authors

Andrzej Kupilas, Mieczysław Fryczkowski, Marcin Życzkowski, Maciej Szczębara, Piotr Bryniarski, Andrzej Paradysz

Katedra i Klinika Urologii w Zabrzu Śląskiego Uniwersytetu Medycznego

summary

Introduction.

The increasing meaning of NSS in pT1a kidney tumor surgery was completely confirmed as in oncological and nephrological point of view. We can observe that indications for NSS have been expanding, including pT1b and pT2 kidney tumors. It brings many questions.

Objective.

Results and tumor progression after 5 years will give the answer whether such treatment is effective or not. The aim of this study is such estimation.

Material and methods. The group of 195 patients, age 25-76, after NSS done 5 to 240 months earlier (mean 75.3 months) was analyzed. They were divided into 3 groups: I – with tumors up to 3 cm in diameter (n-82), II – with tumors up to 5 cm in diameter (n-76), III – with tumors over 5 cm in diameter (n-37).

Results.

We obtain 90.5% of general survival, 92.3% of specific survival and 91.3% without progression. The differences statistically significant in this matter were between I and III group of patients. They were also found in subsequent groups depending on G3-4 presence, obligatory indications for NSS, symptomatic illness.

Conclusion.

1. Size of the kidney tumor in pT1 limits in patients after NSS has the significant influence on the percentage of progression, death rate, kidney failure. 2. Factors that worsen the risk of progression in kidney tumors over 3 cm are: symptomatic illness, obligatory indications for operation, patient with G3-4 tumor. 3. Tumors over 5 cm in diameter are accompanied with higher progression, and lower 6 years survival, especially among men, after tumor enucleation, in G2 and G3-4 tumors.