urovestВестник урологииUrology Herald2308-6424Rostov State Medical University10.21886/2308-6424-2013-0-3-39-53urovest-72Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWS ARTICLEЗНАЧЕНИЕ ОЦЕНКИ ПОЧЕЧНОЙ ФУНКЦИИ ПРИ ПОЧЕЧНО-КЛЕТОЧНОМ РАКЕVALUE ASSESSMENT OF RENAL FUNCTION IN RENAL CELL CARCINOMAЕвсеевС. В.EvseevS. V.

Кафедра урологии и репродуктивного здоровья человека с курсом детской урологии-андрологии

Department of Urology and Human Reproductive Health with a Course of Pediatric Urology-Andrology

gusev_rost@mail.ruГусевА. А.GusevA. A.

Кафедра урологии и репродуктивного здоровья человека с курсом детской урологии-андрологии

Department of Urology and Human Reproductive Health with a Course of Pediatric Urology-Andrology

gusev_rost@mail.ruГБОУ ВПО РостГМУ Минздрава РоссииРоссияRostov State Medical University, Rostov-on-DonRussian Federation201320092013033953Copyright © Евсеев С.В., Гусев А.А., 20132013Евсеев С.В., Гусев А.А.Evseev S.V., Gusev A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.urovest.ru/jour/article/view/72

Почечно-клеточный рак (ПКР) составляет 90-95% всех опухолевых поражений почки. В России в 2008 г. определено 17 563 новых случаев ПКР. При этом распространенные опухоли встречаются в 45,6% наблюдений. А метастатические формы все еще остаются значимой частью ПКР – 28-32%. В последнее десятилетие доля локализованных опухолей увеличилась до 55,4% и 5-летняя канцерспецифическая выживаемость при локальных формах ПКР составляет 86-98%. Однако,это не сопровождается значительным ростом общей выживаемости. И эта ситуация безусловно нуждается в анализе. Прежде все- го, в оценке влияния хирургического лечения на выживаемость пациентов. Радикальная нефрэктомия по- прежнему остается золотым стандартом хирургического лечения ПКР, в том числе при лечении малых опухолей и производится более, чем в 80% случаев. Оценка влияния хирургии на почечную функцию необходима еще в связи с тем, что у 26% пациентов с локальными опухолями, здоровой противоположной почкой и нормальным предоперационным уровнем креатинина скорость клубочковой фильтрации (СКФ) меньше 60 мл/мин. Даже при исходном уровне СКФ от 60 до 90 мл/мин пациенты, подвергнутые радикальной нефрэктомии, имеют 58% риск снижения ее <60 мл/мин. У этой группы больных в 2 раза повышается риск развития сердечно-сосудистых осложнений и в 4,5 раза риск летального исхода. В течение трех лет после радикальной нефрэктомии у 21,6% пациентов отмечается прогрессия сердечно- сосудистых заболеваний и 6,0% больных умирает от осложнений, связанных с ними.

 

Renal cell carcinoma (RCC) accounts for 90-95% of all neoplastic lesions of the kidney. In Russia in 2008 defined 17 563 new cases of RCC. In this common tumor found in 45.6 % of cases. A metastatic forms are still a significant part of RCC – 28-32%. In the last decade the proportion of localized tumors increased to 55.4% and the 5-year cancer survival for local forms of RCC is 86-98%. However, it is not accompanied by a significant increase in overall survival. This situation is definitely needed in the analysis. First of all, to assess the impact of surgical treatment on survival . Radical nephrectomy remains the gold standard for surgical treatment of RCC, including the treatment of small tumors and produced more than 80% of cases. Assessing the impact of surgery on renal function is necessary also due to the fact that in 26% of patients with localized tumors , the opposite kidney healthy and normal preoperative serum creatinine glomerular filtration rate (GFR ) less than 60 ml/min . Even at baseline GFR from 60 to 90 ml/min, patients subjected to radical nephrectomy have 58% risk reduction of its <60 ml/min. In this group of patients in the 2-fold increased risk of cardiovascular complications and 4.5 times the risk of death. Within three years after radical nephrectomy in 21.6% of patients have progression of cardiovascular disease and 6.0% of patients die from complications associated with them.

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The authors declare that there are no conflicts of interest present.