Prediction of the effectiveness of neoadjuvant targeted therapy in patients with localized renal cell carcinoma
Summary. Objective. Тo determine prognostic criteria of neoadjuvant targeted therapy (TT) efficacy in the treatment of patients with localized renal cell carcinoma (RCC). Маterials and methods. 58 patients with localized RCC, who underwent 2 cycles of neoadjuvant TT in the period from 2017 to 2018 with evaluation of objective response level and subsequent surgical treatment outcomes. Results. Average regression after TT was 20.5±14.3% (95% confidence interval (CI) 16.8–24.3). The size of the RCC decreased in average up to 12.3 mm — from 60.8±19.7 mm (95% CI 55.7–66) to 48.5±16.4 mm (95% CI 44.2±52, 8) (t-test; p<0,001), which allowed to perform partial nephrectomy in 53 cases (91,4%). The Pearson’s correlative analysis showed a reliable dependence (r=0,77613; p<0,001) of localized RCC size after neoadjuvant treatment from prior tumor size before neoadjuvant treatment. There was no dependence between objective tumor response level and tumor size prior to TT. Conclusion. A system for predicting levels of localized RCC regression after TT was developed, which provides a 95% probability of determining efficacy in reducing tumor size and feasibility of such treatment.
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