[The conservative treatment of kidney cancer in middle-aged and elderly patients].
Late results of conservative management were investigated in 102 patients with renal carcinoma. Their ages were 60 to 90. A symptomatologic therapy alone was used in the management of 60 patients, 38 were treated with hydroxyprogesterone capronate and 4 with nolvadex. All the patients suffered from concomitant diseases. The refusals of operative treatment were because of such causes as: 1) extension of the tumor process in 29; 2) severe intercurrent diseases in 41; 3) cancer of a single, single-functioning kidney or the both kidneys in 7; 4) the patients' refusals in 25 patients. After the described treatment 71.6% of them lived 1 year, 36.8%-3, and 26.2%-5 years, that was quite comparable with the postoperative results. Prognostically beneficial treatment criteria were: a patient's age of 70 or more years, the stage T1-2N0M0V0, asymptomatic course of the disease, absence of anemia, accelerated erythrocyte sedimentation rate (ESR) more than 40 mm/h; the tumor size less than 10 cm. The most unfavourable prognostic criteria were: T4 stage of the disease, decrease of a hemoglobin level lees than 80 g/l, tumor size more than 10 cm. No one of the 41 patients who had had at least of these signs survived over 3 years. The use of hydroxyprogesterone capronate had no advantages over the symptomatic therapy and did not prolong a patient's life. A 5-year survival of patients managed on hormonal therapy was 22%, on the symptomatic one, 27.1%.(ABSTRACT TRUNCATED AT 250 WORDS)
Igel'nik
A M
AM
Grishin
M A
MA
Mazanov
G P
GP
Shchurandina
N V
NV
D000077713:17 alpha-Hydroxyprogesterone Caproate; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006908:Hydroxyprogesterones / Q000627:therapeutic use; D007680:Kidney Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013629:Tamoxifen / Q000627:therapeutic use
D000970:Antineoplastic Agents; D006908:Hydroxyprogesterones; D013629:Tamoxifen; D000077713:17 alpha-Hydroxyprogesterone Caproate
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