Changes of the size of localized renal cell carcinoma under the influence of neoadjuvant targeted therapy
Summary. Objective. To determine efficacy of neoadjuvant targeted therapy (TT) in treatment of patients with localized RCC. Маterials and methods. Objective response level and subsequent surgical treatment data of 58 patients with localized renal cell carcinoma (RCC), who underwent 2 cycles of neoadjuvant TT in the period from 2017 to 2018 with. Results. Average regression after TT — 20.5±14.3 (95% confidence interval (CI) 16.8–4.3%). RECIST 1.1 score: stabile disease — 44 (76.9%) cases; partial regression — 14 (24.1%); complete response — 0; progressive disease — 0. Conduction of a neoadjuvant TT led to a decrease in the size of the RCC in average up to 12.3 mm 60.8±19.7 (95% CI 55.7–66) to 48.5±16.4 mm (95% CI 44.2–52.8) (t-test; p<0.001) and increased median remaining functioning parenchyma volume by 21% from 62 (57–77) to 83 (70–90) mm (Mann — Whitney U Test; p<0.001), which allowed to perform partial nephrectomy in 53 cases (91.4%). Conclusion. Conducting neoadjuvant TT in patients with localized RCC resulted in an average regression of tumor by 20.5±14.3%, increase of median remaining functioning parenchyma volume by 21% (p<0.001) and high levels of organ-sparing surgery in the group.
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