ABSTRACT
The study was aimed to determine the role of ki- 67 and vimentin markers in choosing the tactics of surgical treatment of patients with metastatic kidney cancer. The analysis of the results of treatment of 71 patients with metastatic renal cell carcinoma was performed. The first group included 16 (22.5%) patients, who underwent complete removal of distant metastases after nephrectomy. The second group consisted of 55 (77.5 %) patients who underwent cytoreductive nephrectomy only. Immunohistochemical analyses of tissues removed were performed in all patients for the evaluation of ki-67 and vimentin expression levels. When comparing the outcomes of patients after complete removal of metastases depending on the vimentin and ki-67 expression levels (< 10% and > 10%), a significant increase in the cumulative survival in the case of absence of vimentin and ki-67 expression of <10 % (log - rank test, P = 0.0001) was revealed. The same pattern was noted in the group of patients who underwent nephrectomy only. In the absence of expression of vimentin and ki-67 < 10%, survival rate in patients who underwent metastasectomy after nephrectomy was significantly higher compared with patients who underwent nephrectomy only (P = 0.001). In the case of positive expression of vimentin and ki-67 > 10%, differences in survival rate in these groups were not observed (P > 0.082). Thus, an association between the vimentin and ki-67 expression levels and the degree of spread of metastatic renal cell carcinoma was identified: the high level of expression of these markers precludes the increase of life expectancy of patients after removal of all metastases.
