Ukrainian
scientific journal
Urology, Andrology, Nephrology

О.A. Voylenko

The influence of neoadjuvant targeted therapy on the choice of surgical treatment of patients with localized renal cell carcinoma

SUMMARY

Objective. To increase efficacy of localized RCC treatment by developing a combined approach using neoadjuvant targeted therapy (TT).

Маterials and methods. Results of a randomized clinical study evaluating efficacy of neoadjuvant TT in patients with localized RCC. Main group consisted of 58 randomized patients who underwent 2 cycles of neoadjuvant TT, followed by an assessment of its efficacy and surgical treatment (renal resection or nephrectomy); control group included 60 randomized patients who received only surgical treatment.

Results. Average tumor regression after TT was (M±SD (95% CI)) 20,5±14,3 (16.8-24,3)%. The size of RCC decreased in average by 12,3 mm, from (M±SD (95% CI)) 60,8±19,7 (55,7-66) to 48,5±16,4 (44,2±52, 8) mm (t-test; p<0,001). Tumor size reduction in the group of neoadjuvant TT allowed performing partial nephrectomy in 53 cases (91,4%), whereas in the control group, the number of nephron-sparing surgeries was only 20 (33,3%) (x2=42.1; p<0,0001).

Neoadjuvant TT in patients with localized RCC leads to reliable regression of the tumor, which ensures the possibility of conducting organ-sparing surgical treatment in 91.4% of cases (x2=42.1; p<0.0001).