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The influence of tumor size on the long-term results of nephron sparing surgery (NSS) and progression in patients with kidney neoplasm pT1
Article published in Urologia Polska 2008/61/3.

authors

Mieczysław Fryczkowski, Andrzej Kupilas, Piotr Bryniarski, Andrzej Paradysz
Katedra i Klinika Urologii w Zabrzu Śląskiego Uniwersytetu Medycznego w Katowicach

keywords

kidney tumor renis pT1 NSS results progression after 6 years

summary

Introduction.

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

The aim of the study.

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 method.

The group of 195 patients, age 25-76, after NSS done 5 to 240 months earlier (mean 75.3 months) was analysed. 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 obtained 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.

Conclusions.

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 and in RCC clarocellulare.

references

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correspondence

Mieczysław Fryczkowski
Klinika Urologii ŚAM
ul. 3 Maja 13/15
41-800 Zabrze
tel. (032) 251 23 62
piotr.bryniarski@neostrada.pl