Stroy O. The peculiarities of diagnosis, treatment and prognosis in in patients with renal cell carcinoma

The Thesis is dedicated to the issues of diagnosis and design of optimal treatment approaches in renal cell carcinoma (RCC) and small renal masses (SRM) while bearing prognostic factors in mind. The work presents the analysis of multi-factorial assessment and treatment in 742 patients with RCC and SRM. The expression of 508-3р microRNA in the blood of patients with RCC was demonstrated to differ significantly from the expression of the same in the blood of healthy controls. We have determined sensitivity, specificity and cut-off value of this marker. The indications to various surgical procedures in kidneys were established and their efficacy was evaluated. Tumor enucleation and radiofrequency ablation demonstrated their high efficacy in SRM, comparable to that of kidney resection. In retrospective study the PADUA standard scale was confirmed to be of high prognostic value in predicting intraoperative complications of nephron-sparing surgery. Radical nephrectomy and radical nephrectomy without lymphadenectomy were demonstrated to have identical efficacy outcomes in localized RCC (T1-2N0M0). Therefore, radical nephrectomy without lymphadenectomy could be considered an effective treatment option in the above stages of RCC. The Thesis has provided substantiation for the efficacy of using renal artery embolization as a symptomatic management strategy in life-threatening macrohematuria in patients with non-resectable RCC. There were suggested algorithms for treatment selection and prognostication in patients with RCC, using which will allow improving the quality of specialized care in patients with kidney cancer