Poređenje onkoloških ishoda između elektivne parcijalne i radikalne nefrektomije kod bolesnika sa karcinomom bubrežnih ćelija CT1B stadijuma
Sažetak
Uvod/Cilј. Kod karcinoma bubrežnih ćelija (KBĆ) izbor hirurške tehnike – radikalne (RN) ili parcijalne nefrektomije (PN) i dalje zavisi od centra gde se resekcija vrši, jer i dalje nema apsolutnih preporuka u vezi sa izborom pristupa. Cilj studije bio je da se analiziraju onkološki aspekti bolesnika sa KBĆ u stadijumu T1bN0М0 u zavisnosti od tipa primenjene hirurške procedure – PN ili RN. Metode. Kliničkom opservacionom studijom tipa serije slučajeva analizirani su podaci 154 bolesnika koji su operisani na Klinici za urologiju Vojnomedicinske akademije, Beograd, Srbija, sa prosečnim periodom praćenja ne kraćim od 5 godina. Bolesnici su bili podeljeni u dve grupe: grupu bolesnika sa RN i grupu bolesnika sa PN. Kriterijumi za uklјučivanje u studiju bili su: tumori bubrega veličine 4–7 cm, patohistološki postavlјena dijagnoza KBĆ, odsustvo metastaza i vrednosti serumskog kreatinina u referentnim granicama. Kriterijumi za isklјučivanje bolesnika iz kliničkog ispitivanja bili su: prisustvo drugih maligniteta, prisustvo drugog funkcionalnog bubrega ili obolјenja koja mogu kompromitovati bubrežnu funkciju, bilateralni tumori i više tumora na jednom bubregu. Rezultati. U studiji su analizirani podaci od ukupno 154 bolesnika, 97 (63%) sa RN i 57 (37%) sa PN. Analizirajući preživljavanje bolesnika, u zavisnosti od tumora, utvrđeno je da je kod četiri bolesnika sa RN došlo do smrtnog ishoda zbog napredovanja bolesti, dok je kod jednog bolesnika sa PN smrtni ishod nastupio kao posledica lokalnog recidiva tumora i udaljenih metastaza. Zaklјučak. Na osnovu naših rezultata, PN je dobar i siguran izbor u lečenju bolesnika sa KBĆ u T1b stadijumu. Parcijalne nefrektomije nudi sličnu kontrolu tumora i bolјe preživlјavanje obolelih od KBĆ.
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