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Naveed Ahmad Khan
Resident Urology Institute of Kidney Diseases, Pakistan
Posters & Accepted Abstracts: Clin Nephrol Res
Background: Managing the recurrence of renal tumor in renal bed without metastasis is surgical challenge for the urologists. The extent of recurrence, size, time and vascular involvement are all the prognostic indicators for overall survival and cancer free survival of renal tumors. Ki 67 is a non-protein histone antigen. The role of over expression of Ki 67 at molecular level is dubious as there has been conflicting results in literature. Department of Urology at Institute of Kidney Diseases is a busy tertiary care hospital dealing with renal tumors. Objective: To study the predictive value of over expression of Ki 67 in recurrence, tumor free survival and 5 year survival rate in renal tumor Methods: It is a descriptive study that was conducted in Team C Urology at Institute of Kidney Diseases HMC Peshawar from 2017-June 2021. Total numbers of 8 cases with recurrence of growth were recorded by non-probability consecutive sampling. Resection of the recurrence of tumor bed was performed in all cases. The preoperative, intraoperative and postoperative details were recorded on structured proforma and were analyzed on SPSS. Results: We have performed 430 radical nephrectomies from 2017 till June 2021. We recorded 8 cases of recurrence of growth in renal bed accounting 1.8 % of total. The mean time to recurrence was 18±3 months (Average 3 months till 4 years). The recurrence was picked during follow up ultrasounds with mean size of recurrence was 8.5±4cm. It was confirmed by CT scan. In Toto excision was successful in 7 cases while 1 patient required Hartsman procedure as tumor had eroded the colon. Out of 8, Chromophobe carcinoma was found in 5 while 3 had clear cell carcinoma. Ki67 was positive in all 5 cases of chromophobe cell carcinoma and 2 cases of clear cell carcinoma. We recorded mortality in 3 patients of chromophobe cell carcinoma and 1 patient of clear cell carcinoma with median follow up of 30 months. Conclusion: Ki 67 is poor prognostic indicator for recurrence of renal tumor.
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