SUBSTANTIATION OF KIDNEY RESECTION FOR RENAL CELL CARCINOMA GRADE I WITH TUMOR SIZE MORE THAN 4 cm
Objective. The purpose was an analysis of the remote outcomes of the organ saving (resection) and organ losing (nephrectomy, nephadrenalectomy) methods of treating patients with renal cell carcinoma (RCC) grade I the tumor size being more than 4 cm. Materials and methods. The data about the patients the RCC grade I (pT1N0M0) diagnose confirmed morphologically and treated according the radical program at the Department for Oncourological Pathology of the RSPC for Oncology and Medical Radiology named after N. B. Aleksandrov in 1998 — 2008 were analyzed. Results. The observation period median was 53.5 months. The total 5-year survival was 94.3% (CI 92.1 — 95.9), the adjusted 5-year survival was 97.4% (CI 95.9 — 98.5). For patients with ESR exceeding 30 mm/ h the adjusted 5-year survival was 86.7±7.1%, the total one - 82,6±7,9% whereas when the ERS values were lower 30 mm/h those indices were 98.2±1.2% and 95.0±2.0%, respectively. The adjusted total survival after resections was higher than after nephrectomies being 99.0±0.6% vs 96.5±1.3% and 96.3±1.1% vs 92.7±1.6%, respectively by the 5th year. Conclusion. The ESR values have been confirmed to be a predictive factor influencing the adjusted and total survival rates of the RCC grade I patients their tumors size being more than 4 cm (р=0,005 and р=0,025, respectively). It has been determined that the remote results of the organ saving surgeries for neoplasms exceeding 4 cm are comparable with those when the organ losing techniques have been used.