The effect of surgical treatment on the quality of life of kidney cancer patients with single bone metastases

Abstract

BACKGROUND: Renal cell cancer is complicated with bone metastases quite often, which are determined in a third of patients at the time of diagnosis of the primary tumor. The development of skeletal complications causes the complexity of managing such patients, which requires optimizing treatment tactics using combined methods and improving the quality of life after treatment.

AIM: The aim of this study is to assess the quality of life of renal cell cancer patients with single metastases in the bones before and after surgical treatment in combination with targeted therapy and without it.

MATERIALS AND METHODS: The study included 62 patients with single bone metastases of renal cell cancer with the presence of skeletal related events. 20 patients (group 1) underwent surgical treatment of metastases after surgery on the primary focus in combination with targeted therapy, 42 patients (group 2) underwent only surgical treatment of metastases. The quality of life was assessed using the EORTC QLQ-C30 questionnaire before and after surgery within and between groups.

RESULTS: Comparison of the survey influence on life quality in group 1 before and after treatment revealed that 8 out of 30 indicators of the EORTC QLQ-C30 questionnaire did not show a statistically significant change. These include: any restrictions in daily activities, as well as doing what you like, decreased appetite, nausea, shortness of breath, diarrhea, fatigue, financial difficulties. The remaining 22 indicators of the scale showed a statistically significant improvement. Comparison of quality of life indicators in group 2 before and after treatment showed that for 3 out of 30 indicators of the EORTC QLQ-C30 questionnaire, no statistically significant changes were registered, among them: the severity of pain syndrome, the presence of financial difficulties and health status over the past week. Statistically significant improvement was revealed for the remaining 27 indicators of the scale. Prior to treatment, difficulties in taking a short walk, doing daily chores, doing favorite things are more pronounced in group 1, and the need for rest in group 2 patients. After surgery, the indicators associated with daily activity were worse in group 1 patients, while the severity of the pain syndrome, its effect on daily activity, the need for rest, a sense of tension, and the effect on the emotional background were more noticeable in group 2 patients. Both before and after surgery, group 1 patients had a better assessment of both their health and quality of life over the past week.

CONCLUSIONS: The comparative analysis of the treatment confirmed our hypothesis that the most rational and effective combination is an active surgical tactic in combination with targeted therapy for bone oligometastases of renal cell cancer.

Keywords

renal cell cancer / bone metastases / single metastases / management tactics / quality of life

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