Surgical Management of Recurrences of Renal Cell Carcinoma

Abstract

In recent decades the detection of new cases of renal cell carcinoma (RCC) has remained unchanged. This tumor accounts for 2-3% of all cancer diagnoses in humans. Standard methods of surgical treatment are being improved towards less invasive resection methods; this let’s achieving the outcomes comparable to traditional nephrectomy in oncological practice. In some cases the risk factor of developing locoregionalrecurrence still remains after surgical treatment for renal cancer. The limited role of systemic therapy and radioresistance sets hopes on surgical removal of the recurrent tumor. Unfavorable prognostic factors such as the volum of recurrence, the presence of sarcomatoid histological elements, an increased level of serum alkaline phosphatase and lactate dehydrogenase were identified in the materials of several recent studies. The time of recurrence appearance and aforehandsurgeries hould be defined as one of the independent predictors as it reported by other several studies. The open laparotomic, laparoscopic and robotic methods of tumor removal, as well as the extents of renal segments of repeated resection are discussed depending on the size of the recurrent tumor and the extent of the previous opetations. At the present stage of the development of minimally invasive surgery, with its problem-solvingabilities which are very essential in treating the relapsed high-riskpatients.

Renal function, endotoxicosis, and oxidative stress in patients after open and laparoscopic nephrectomy

“…В последние годы рак почки (РП) в России составляет 3,8 % всех случаев рака и является одной из наиболее значимых онкологических патологий, что обусловлено целым рядом факторов: неуклонным ростом заболеваемости за последние два десятилетия (19,3 % у мужчин и 23,5 % у женщин), большим количеством пациентов (заболеваемость составляет 1,14-7,90 на 100 000 населения), средним возрастом пациентов (47-69 лет), частыми рецидивами болезни (в 30-40 % случаев), поздним проявлением клинических симптомов, диагностической сложностью, малоэффективной тактикой лечения [1][2][3][4].…”