engleski

Postoperative survival rate in patients with renal tumors : A 23 year retrospective analysis

In 196 patients with malignant renal tumors nephrectomy was performed between 1972. and 1995. y. ( 104 men and 92 women ). 10 male (9,6 % ) and 16 women ( 17.3 % ) died in this period. The cause of death was not analyzed. The information dead/alive was obtained by police authorities. In males the mean age at the operation was 57,8 and in females 59.7 y. Kaplan Meier survival analysis of total group indicated 90 per cent alive patients after 2 years and 80 per cent after 10 years. The survival curve sharply decreases after 20 years obviously aging mortality. Women had significantly higher mortality (log rank test p=0.05), 30 per cent of them died in first 10 years. T3 and T4 tumors had significantly higher mortality than T1 or T2 tumors (log rank test). Amazingly, there were no surviving differences in comparison between the M0 and M1 groups. We supposed that the preoperative diagnosis of eventual distant metastases is quite unreliable. The survival rate in N 0 tumors was significantly higher than in N 1 tumors bat only during the first 7.5 years. Lately the curves showed approximately the same level (without statistical difference). We also compared the survival rates between the various operative approaches to the kidney: The classical lumbar extraperitoneal approach did not present the worse results than the radical transabdominal or even transthoracoabdominal operation. Graphic survey and log rank test did not show any significant difference between the groups. The radical lymphadenectomy (52 patients) also showed no significant improvements in comparison with nonlymphadenectomy group. Analyzing the 26 died persons, we found that 5 died in perioperative time (3 months), 13 died during the first 2 years. After 5 years the death was sporadic and after 20 years it increased again.

renal tumors

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