Pertiia A R, Managadze L G
Urologiia. 2006 May-Jun(3):17-9.
Radical nephrectomy was made in 483 patients with renal cell carcinoma (RCC) without metastases admitted to National Urology Center in 1989-2004. Isolated local recurrence was observed in 10 (2.07%) patients who were divided into two groups. The recurrent tumor was removed in 6 patients of group 1, four patients of group 2 received conservative treatment. Statistic processing was made with Kolmogorov-Smirnov test and unmatched t-test. Survival was estimated according to Kaplan-Meyer, significance of the differences--by log rank test. Three patients of group 1 died of progression of basic disease. Only 1 patient from group 2 was alive 22 months after detection of the recurrence. Mean survival in group 1 was 27.5 +/- 14.9 months, in group 2--10 +/- 8.5 months (p = 0.045). A mean size of the recurrent tumor in survivors was 5.4 +/- 2.1 cm, while in dead patients--10.05 +/- 2.76 cm (p = 0.02). Radicalism of the recurrent tumor removal influenced survival of the patients (p = 0.019). In survivors local recurrence developed 35.7 +/- 28.1 months after radical nephrectomy; in the deceased the recurrence arose 23.3 +/- 25.5 months after nephrectomy (p = 0.46). Thus, early detection of isolated local recurrence of a relatively small size allows complete recovery in some surgically treated patients.
1989年至2004年期间，483例无转移的肾细胞癌（RCC）患者在国立泌尿外科中心接受了根治性肾切除术。10例（2.07%）患者出现孤立性局部复发，这些患者被分为两组。第一组6例患者的复发性肿瘤被切除，第二组4例患者接受了保守治疗。采用Kolmogorov-Smirnov检验和非配对t检验进行统计学处理。根据Kaplan-Meyer法估计生存率，差异显著性采用对数秩检验。第一组3例患者死于基础疾病进展。第二组仅1例患者在复发检测后22个月仍存活。第一组的平均生存期为27.5±14.9个月，第二组为10±8.5个月（p = 0.045）。存活患者复发性肿瘤的平均大小为5.4±2.1 cm，死亡患者为10.05±2.76 cm（p = 0.02）。复发性肿瘤切除的根治性影响患者的生存（p = 0.019）。存活患者在根治性肾切除术后35.7±28.1个月出现局部复发；死亡患者在肾切除术后23.3±25.5个月出现复发（p = 0.46）。因此，早期发现相对较小的孤立性局部复发可使部分接受手术治疗的患者完全康复。
