Peculiarities of morphological changes in estimation of efficacyof neoadjuvant targeted therapy in patients, suffering localizedrenal–cell cancer

Keywords: renal–cell carcinoma; neoadjuvant targeted therapy

Abstract

Objective. To determine the peculiarities ofmorphological changes under the influence of neoadjuvant targeted therapy (TTH) in patients, suffering localized renal-cell cancer (RCC).

Маterials and methods. The investigation was performed in 58 patients, suffering localized RCC, in whom two blocks of neoadjuvant TTH were conducted for determination of objective answer on treatment accomplished with further operative intervention and pathomorphological investigation.

Results. Median index of tumoral regression (М ± SD) after conduction of ТТH have constituted (20.5 ± 14.3)% (95% confidence interval - CІ 16 - 24.3). Estimation of tumoral regression in accordance to RECIST 1.1 have witnessed, that stabilization was registered in 44 (75.9%) patients, and partial regression - in 14 (24.1%). Сomplete regression or progression of the process was not observed in any patient. Median index of regression while presence of the Degree II process, in accordance to Furman method, have constituted (22.6 ± 14.4)% (95% CІ 18.3 - 26.9); Degree III in accordance to Furman method - (17.1 ± 11.7) (95% CІ 7.3 - 26.9); and the Degree IV in accordance to Furman method - (3.8 ± 2.9)% (95% CІ -1 - 8,5); estimation in accordance to ANOVA method: η2=0.13; power=0.72; p < 0.05. Median index of tumoral necrosis under the impact of ТТH is trustworthily higher in patients with partial regression. Correlation dependence of the vascular changes severity and viable part of tumoral tissue from degree of the RCC regression was not revealed.

Conclusion. Tumoral regression by (20.5 ± 14.3)% at average  have occurred under the impact of neoadjuvant TTH in patients, suffering localized RCC. Low index of the RCC regression in patients, having histopathological nuclear Degree IV in accordance to Furman method have constituted (3.8 ± 2.9)%, what witnessed low TTH efficacy (estimation in accordance to ANOVA method: η2 = 0.13; power = 0.72; p < 0.05), and may be applied as a prognostic marker of answer. 

Author Biographies

O. A. Voylenko, National Cancer Institute, Кyiv

Voylenko Oleg A. - MD, PhD (Med),
Senior Researcher of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 050 501 19 03
voilenko@rambler.ru
https://orcid.org/0000-0003-3781-3622

V. M. Nepomnyaschy, Іnstitute of Nephrology, Kyiv

Nepomnyaschy Valentin N. - MD, PhD (Med),
Head of Department Pathomorphology,
Institute nephrology АМS,
17 B Dehtiarivska Str., 04050, Kyiv, Ukraine
+38 067 502 62 24
nepo2@ukr.net
https://orcid.org/0000-0002-6730-7678

O. E. Stakhovskyi, National Cancer Institute, Кyiv

Stakhovskyi Oleksandr E. - MD, PhD (Med),
Senior Researcher of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 050 381 72 17
stakhovsky9@gmail.com
https://orcid.org/0000-0002-0030-5459

Yu. V. Vitruk, National Cancer Institute, Кyiv

Vitruk Iurii V. - MD, PhD (Med),
Senior Researcher of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 050 673 20 82
uvitruk@ukr.net
https://orcid.org/0000-0003-3466-0552

O. A. Kononenko, National Cancer Institute, Кyiv

Kononenko Oleksii A. - MD, PhD (Med),
Researcher of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 097 269 32 35
kononenko_ol@ukr.net
https://orcid.org/0000-0002-7081-5964

M. V. Pikul, National Cancer Institute, Кyiv

Pikul Maksym V. - MD,
Urologist of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 093 205 06 96
urogenetics@gmail.com
https://orcid.org/0000-0003-1590-235X

S. L. Semko, National Cancer Institute, Кyiv

Semko Sofiya L. - MD,
Urologist of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 063 252 65 36
semkosofiya@gmail.com
https://orcid.org/0000-0002-1657-5752

E. O. Stakhovsky, National Cancer Institute, Кyiv

Stakhovsky Eduard O. - MD, Doctor of Science (Med), Professor,
Head of Department of Plastic and Reconstructive Oncological Urology,
National Cancer Institute,
33/43 Lomonosova Str., 03022, Kyiv, Ukraine
+38 067 236 51 75
estakhovsky@yahoo.com
https://orcid.org/0000-0001-5677-8768

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Published
2019-02-28
How to Cite
Voylenko, O. A., Nepomnyaschy, V. M., Stakhovskyi, O. E., Vitruk, Y. V., Kononenko, O. A., Pikul, M. V., Semko, S. L., & Stakhovsky, E. O. (2019). Peculiarities of morphological changes in estimation of efficacyof neoadjuvant targeted therapy in patients, suffering localizedrenal–cell cancer. Klinicheskaia Khirurgiia, 86(3), 32-36. https://doi.org/10.26779/2522-1396.2019.03.32
Section
General Problems of Surgery