Renal cancer resection with targeted balloon chemoembolization

Abstract

The purpose of the study was to evaluate the content of endothelial vascular growth factor in the tissues of the kidney parenchyma, in the thickness of the tumor and in the blood serum of a patient during partial nephrectomy with intra-arterial administration of an anti-angiogenic drug.

Materials and research methods. The present study was carried out on the basis of an analysis of the results of surgical treatment of patients with kidney cancer. 8 patients with renal cell carcinoma in stage T 1 a N 0 M 0 organ-preserving surgery was performed in the amount of kidney resection with intra-arterial injection of the targeted drug Bevacizumab into the kidney artery. The concentration of vascular growth factor in the tumor, in the renal parenchyma, and in venous blood from the kidney was studied before the renal artery was clamped, during renal ischemia, and after the injection of Bevacizumab into the renal artery.

Results and discussion. With a sudden cessation of blood flow, the tumor releases the amount of vascular growth factor several times higher than the initial values: an increase in the concentration in the thickness of the tumor by 3 times, in the kidney parenchyma - 1.5 times, and in the venous blood - 3.5 times higher than before ischemia. Inactivation of the growth factor by the targeted drug caused a decrease in its level in the tumor tissue by 25%, in the kidney parenchyma by 10% and in the blood serum by 85.35%.

Conclusion. Intraoperative administration of a targeted drug at the time of acute tumor ischemia irreversibly binds the vascular growth factor released during hypoxia, and thus prevents neoangiogenesis in potential metastatic foci.