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Titel: Elective nephron sparing surgery in 69 patients with renal cell carcinoma > 4 cm
Verfasser: Becker, Frank
Siemer, Stefan
Humke, Ulrich
Ziegler, Manfred
Stoeckle, Michael
Sprache: Englisch
Erscheinungsjahr: 2005
Quelle: 20th Congress of the European Association of Urology, Istanbul 2005
SWD-Schlagwörter: Hypernephrom
Nierentumor
Nierenkrebs
Nephrektomie
Niere
Nierenfunktion
Organerhaltung
Freie Schlagwörter: Nierenteilresektion
Nierenzellkarzinom
elektiv
nephron sparing surgery
elective
renal cell carcinoma
DDC-Sachgruppe: 610 Medizin, Gesundheit
Dokumentart : Sonstiges (Statistische Berichte, Technische Dokumentationen u.ä.)
Kurzfassung: Purpose: After establishment of nephron-sparing surgery as accepted technique — both in imperative and in elective indications, in tumors < 4 cm and healthy contralateral kidney — the question, according long-term results in elective nephron-sparing surgery in tumors larger than 4 cm, came up. In this unicentric, retrospective longitudinal analysis, results, survival and outcome of this selected group of patients is described. Material and methods: Between 1975 and 2003, 94 patients with kidney-tumors > 4 cm in diameter and healthy contralateral kidney, were treated by open nephron-sparing surgery. 69 of them had in histological findings renal cell carcinomas (73.4 %). Feedback in 86.2 % of patients was obtained in a current follow-up. Mean observation-time after surgery was at 6.2 years. Results: 84.1 % of tumors were found accidentally. Tumors were mostly (88.3 %) resected by warm ischemia. Mean time of ischemia was at 17.2 minutes at a mean operation-time of 122.3 minutes. Complications occurred in 12.8 %, whereas only in 2 cases a secondary operation was necessary, in which always remaining kidneys could be saved. Mean diameter of renal cell carcinomas was at 5.33 cm (range: 4.1 to 10.0 cm). Tumor-stage was mostly (89.9 %) at pT1b (TNM-classification from 2002). 2 patients showed perioperatively metastasis, which were resected successfully by secondary surgery. In the observation-time of 6.2 years, 7 patients died but not in case of tumor. So the long-term survival was at 94.9 % (5-year-survival) respectively 86.7 % (10- and 15-year-survival). Tumorspecific survival was after 5, 10 and 15 years always at 100 %. Conclusion: After establishment of nephron-sparing surgery as standard procedure for renal tumors smaller than 4 cm by healthy contralateral kidney, in most urological centres, a size of 4 cm should not considered as fixed limit for these indications. After detailed selection of patients, surely excellent results in elective nephron-sparing surgery in tumors larger than 4 cm can be achieved.
Link zu diesem Datensatz: urn:nbn:de:bsz:291-scidok-4788
hdl:20.500.11880/20788
http://dx.doi.org/10.22028/D291-20732
SciDok-Publikation: 10-Nov-2005
Fakultät: Fakultät 2 - Medizin
Fachrichtung: M - Urologie und Kinderurologie
Fakultät / Institution:M - Medizinische Fakultät

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