CHANGES IN BIOLOGY OF RENAL CELL CARCINOMA: COMPARISON OF TWO DECADES IN ONE HEALTH CENTER

Introduction. Epidemiological studies noted a progressive increase in the incidence of renal cell carcinoma (RCC). Despite the improvement in radiation diagnosis of RCC, the number of primary metastatic forms and number of secondary progressive forms after radical surgical treatment remains high with no apparent downward trend. This may be due to changes in the biology of RCC, which is expressed in the increasing aggressiveness of the tumor tissue. However, studies on the biological characteristics of the change in tumor for a long period of time is very small.

Objective. To evaluate and compare the profiles of patients with RCC, the morphological characteristics of renal tumors, the options for surgical treatment and its results in two consecutive decades.

Materials and methods. The study included 306 operated and monitored patients with RCC. The patients were divided into two groups: 1 group - 149 patients treated from 1996 to 2005 and 2 group - 157 patients treated from 2006 op 2015. The group analyzed the profiles of patients and morphological characteristics of the tumor.

Results. In patients of the group 2, tumors >4 cm were characterized by a lower degree of tissue differentiation (G2-G3) compared to the group 1 (54.54% vs. 48.57%) and T3a (60% vs. 42.26%). A similar difference was noted for tumors measuring 4-7 cm (G2-G3 - 67.69% vs. 57.75%, T3a - 79.54% vs. 32.15%). Tumors of the group2 in the stages Tla, Tib, T2 and T3a are less frequent had a high degree of differentiation (Gl) in comparison with tumors of similar stages of group 1 (52.17% vs. 59.26%, 35.71% vs. 58.06%, 11.11% vs. 18.75% and 12.12% vs. 28%, respectively.) In the group 2, regional and distant metastasis was noted more often than in group 1 (34.6% vs. 20.33%). Survival in group 2 decreased in comparison with group 1 (3-year-old: total - 78.37% vs. 83.02%, oncological - 81.43% vs. 87.15%, 5-year-old: total - 73.86% vs. 79.21%, oncological - 78.69% vs. 83.91% ).

Conclusions. The comparative analysis showed an increase in aggressive tumor potential in group 2 compared to group 1.

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