| Abstract | CILJ ISTRAŽIVANJA: Usporedba patohistoloških obilježja raka bubrega (gradus, TNM stadij, veličina tumora) nakon kirurškog liječenja u KBC-u Split između dva četverogodišnja perioda
MATERIJALI I METODE: Provedena je retrospektivna studija u 618 bolesnika koji su kirurški liječeni zbog raka bubrežnih stanica na Zavodu za urologiju KBC-a Split u periodu od 1. siječnja 2012. godine do 31. prosinca 2019. godine. Podatci su prikupljeni na Zavodu za urologiju KBC-a Split, iz Operativnih protokola, pismohrane povijesti bolesti i patohistoloških potvrda dijagnoze raka bubrega. Bolesnici su podijeljeni u dva četverogodišnja perioda. Prvi period uključuje bolesnike koji su operirani od 1. siječnja 2012. do 31. prosinca 2015. godine, a Drugi period uključuje bolesnike operirane od 1. siječnja 2016. do 31. prosinca 2019. godine. U studiju su uključeni samo bolesnici operirani zbog raka bubrežnih stanica, a isključeni su bolesnici operirani zbog drugih malignih i benignih novotvorina bubrega te oni kojima je učinjena samo biopsija bubrega.
REZULTATI: U studiju je uključeno 633 bolesnika(450M, 183Ž) koji su podvrgnuti parcijalnoj ili radikalnoj nefrektomiji. U prvom Periodu bilo je 304 bolesnika (210M, 94Ž), a u Drugom periodu 329 (240M, 89Ž). Srednja dob bolesnika u oba perioda je usporediva (64 vs 65 godina). U oba perioda incidencija bolesti je veća u muškaraca nego u žena (omjer M:Ž; 2,5:1). Veličina tumora je nešto manja u Drugom nego u Prvom periodu (5,44cm vs 5,15cm). Udio lokalno ograničenih tumora (pT1 i pT2) porastao je s 70,3% na 76,3%, dok se s druge strane udio lokalno uznapredovalih tumora (pT3 i pT4) smanjio s 29,7% na 23,7% (p>0,05). Gradus 2 je u obe populacije najčešće zastupljen gradus s neznatnim promjenama i prosječnim udjelom od oko 48%. U Drugom periodu bilo je više bolesnika s tumorom gradusa 1, nego u Prvom istraživanom periodu (26% vs 12%, p<0,05). Bolesnici u Prvom periodu imaju veći udio gradusa 4, nego bolesnici u Drugom periodu (14% vs 8,4%, p=0,08). Najčešći tip u obe populacije bio je svijetlostanični tip s prosječnim udjelom od 76% U Drugom periodu istraživanja više bolesnika je s manje agresivnim histološkim podtipovima tumora (papilarni tip 15% vs 12%; papilarni tip 2 52% vs 26%; kromofobni 4% vs 6%, nediferencirani 2% vs 4%). Broj i odnos radikalnih i parcijalnih nefrektomija nije se mijenjao.
ZAKLJUČAK: U našoj studiji nakon kratkog praćenja od svega 8 godina uočili smo stabilnu incidenciju raka bubrežnih stanica, veću incidenciju raka u muškaraca, te manju pojavnost agresivnih oblika raka bubrežnih stanica tijekom praćenja. |
| Abstract (english) | OBJECTIVES: Comparison of pathohistological features of kidney cancer (grade, TNM stage, tumor size) after surgical treatment at the University Hospital of Split between two four-year periods
MATERIALS AND METHODS: A retrospective study was conducted in 618 patients who were surgically treated for renal cell carcinoma at the Department of Urology, University Hospital Center Split in the period from Jan 1st 2012 to Dec 31st 2019. Data were collected at the Department of Urology of the University Hospital of Split, from the Operational Protocols, the archival history of the disease and the pathohistological confirmations of the diagnosis of kidney cancer. Patients were divided into two fouryear periods. The first period includes patients who underwent surgery from Jan 1st 2012 to Dec 31st 2015, and the second period includes patients who underwent surgery from Jan 1st 2016 to Dec 31st 2019. The study included only patients operated on for renal cell carcinoma, and excluded patients operated on for other malignant and benign renal neoplasms and those who underwent only a kidney biopsy.
RESULTS: The study included 633 patients (450M, 183F) who underwent partial or radical nephrectomy. In the first period there were 304 patients (210M, 94F), and in the second period 329 (240M, 89F). The mean age of patients in both periods was comparable (64 vs 65 years). In both periods, the incidence of the disease is higher in men than in women (ratio M:F; 2,5: 1). Tumor size was slightly smaller in the Second than in the First period (5.44 cm vs 5.15 cm). The share of locally restricted tumors (pT1 and pT2) increased from 70.3% to 76.3%, while on the other hand the share of locally advanced tumors (pT3 and pT4) decreased from 29.7% to 23.7% (p> 0.05). Gradus 2 is the most common grade in both populations with slight changes and an average share of about 48%. In the Second period, there were more patients with grade 1 tumor than in the First study period (26% vs 12%, p <0.05). Patients in the First Period have a higher proportion of grade 4 than patients in the Second Period (14% vs 8.4%, p = 0.08). The most common type in both populations was the light cell type with an average proportion of 76%. In the Second study period, more patients had less aggressive histological tumor subtypes (papillary type 1 5% vs 12%; papillary type 2 52% vs 26%; chromophobic 4% vs 6%, undifferentiated 4% vs 2%). The number and ratio of radical and partial nephrectomies did not change.
CONCLUSION: In our study, after a short follow-up of only 8 years, we observed a stable incidence of renal cell carcinoma, a higher incidence of cancer in men, and a lower incidence of aggressive forms of renal cell carcinoma during follow-up. |
