Quality of life in patients, suffering localized reno-cellular cancer after operative treatment
Abstract
Objective. To rise the efficacy of treatment in patients, suffering localized reno-cellular cancer (LRCC), studying quality of life in patients and determination of optimal procedure of operative treatment.
Materials and methods. Of 511 patients, suffering LRCC (T1-T2 N0M0), in whom quality of life was estimated in accordance to the SF-36 questionnaire, renal resection was performed in 422 (82.6%), nephrectomy - 89 (17.4%). The observation duration median have constituted 28.9 mo (from 3 to 131 mo).
Results. A patient’s cognition of the oncological disease missing have raised the quality of life self-estimation, predominantly in accordance to indices of psychological component of health after nephrectomy and after renal resection. Comparing the quality of life between the patients’ groups, there was obtained a statistically significant advantage of renal resection over nephrectomy in accordance to five indices of quality of life, including: physical functioning - 75 [65; 85] points after nephrectomy and 80 [70; 90] points after renal resection (p < 0.005); general state of health - 65 [57; 72] and 70 [65; 80] (p < 0.001); vital activity - 65 [55; 70] and 70 [60; 75] (p < 0.005); psychological health - 76 [60; 80] and 80 [68; 88] (p < 0.005); the emotionally-role functioning - 66.7 [66.7; 100] and 100 [66,7; 100] (p < 0.05) points, accordingly.
Conclusion. Renal resection has a statistically proven advantage over nephrectomy in accordance to patients’ quality of life, determined, basing on data from the SF-36 questionnaire, predominantly due to better psychological self estimation of the patient’s state of health (p < 0.01). Difference between the investigated groups in accordance to indices of pain intensity, social and physical-role functioning was not established.
References
GLOBOCAN 2018; Accessed Jun.2019 http://globocan.iarc.fr.
Ljungberg B, Hanbury DC, Kuczyk MA, Merseburger AS, Mulders PF, Patard JJ, et al. EAU Renal Cell Carcinoma Guideline. Eur Urol. 2007;51(6):1502-10. doi: 10.1016/j.eururo. 2007.03. 035.
Smith DH, Thorp ML, Gurwitz JH, McManus DD, Goldberg RJ, Allen LA, et al. Chronic kidney disease and outcomes in heart failure with preserved versus reduced ejection fraction: the Cardiovascular Research Network PRESERVE Study. Circ Cardiovasc Qual Outcomes. 2013;6(3):333-42. doi: 10.1161/CIRCOUTCOMES.113.000221.
Huang WC, Levey AS, Serio AM, Snyder M, Vickers AJ, Raj GV, et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. Lancet Oncol. 2006 Sep;7(9):735-40. doi: 10.1016/S1470-2045(06)70803-8.
Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, et al. European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. Eur Urol. 2019;75(5):799-810. doi: 10.1016/j.eururo.2019.02.011.
Kutikov A, Uzzo RG. The R.E.N.A.L. nephrometry score: a comprehensive standardized system for quantitating renal tumor size, location and depth. J Urol. 2009;182(3):844-53. doi: 10.1016/j.juro.2009.05.035.
Shuch B, Crispen PL, Leibovich BC, LaRochelle JC, Pouliot F, Pantuck AJ, et al. Cardiopulmonary bypass and renal cell carcinoma with level IV tumour thrombus: can deep hypothermic circulatory arrest limit perioperative mortality? BJU Int. 2011;107(5):724-8. doi: 10.1111/j.1464-410X.2010.09488.
Ficarra V. Open radical nephrectomy versus open partial nephrectomy: is it still an issue? Eur Urol. 2007;51(3):593-5. doi: 10.1016/j.eururo.2006.11.031.
Porpiglia F, Volpe A, Billia M, Scarpa RM. Laparoscopic versus open partial nephrectomy: analysis of the current literature. Eur Urol. 2008;53(4):732-42; discussion 742-3. doi: 10.1016/j.eururo.2008.01.025.
Lesage K, Joniau S, Fransis K, Van Poppel H. Comparison between open partial and radical nephrectomy for renal tumours: perioperative outcome and health-related quality of life. Eur Urol. 2007;51(3):614-20. doi: 10.1016/j.eururo.2006.10.040.
Sprangers MA, Cull A, Groenvold M, Bjordal K, Blazeby J, Aaronson NK. The European Organization for Research and Treatment of Cancer approach to developing questionnaire modules: an update and overview. EORTC Quality of Life Study Group.Qual Life Res. 1998;7(4):291-300. PMID:9610213.
Shinohara N, Harabayashi T, Sato S, Hioka T, Tsuchiya K, Koyanagi T. Impact of nephron-sparing surgery on quality of life in patients with localized renal cell carcinoma. Eur Urol. 2001;39(1):114-9, doi: 10.1159/000052422.
Poulakis V, Witzsch U, de Vries R, Moeckel M, Becht E. Quality of life after surgery for localized renal cell carcinoma: comparison between radical nephrectomy and nephron-sparing surgery. Urology. 2003;62(5):814-20. doi:10.1016/s0090-4295(03)00687-3.
Gratzke C, Seitz M, Bayrle F, Schlenker B, Bastian PJ, Haseke N, et al. Quality of life and perioperative outcomes after retroperitoneoscopic radical nephrectomy (RN), open RN and nephron-sparing surgery in patients with renal cell carcinoma. BJU Int. 2009;104(4):470-5. doi: 10.1111/j.1464-410X.2009.08439.
Hollingsworth JM, Miller DC, Daignault S, Hollenbeck BK. Five-year survival after surgical treatment for kidney cancer: a population-based competing risk analysis. Cancer. 2007;109(9):1763-8. doi: 10.1002/cncr.22600.

This work is licensed under a Creative Commons Attribution 4.0 International License.