Epidemiology of Lung Cancer in Kazakhstan: Trends and Geographic Distribution.

OBJECTIVE: The aim is to study the trends of lung cancer (LC) incidence in the regional context in Kazakhstan. METHODS: The retrospective study was done using descriptive and analytical methods of oncoepidemiology. The extensive, crude and age-specific incidence rates are determined according to the generally accepted methodology used in sanitary statistics. The data were used to calculate the average percentage change (APС) using the Joinpoint regression analysis to determine the trend over the study period. RESULTS: Over the 10 years under study, 36,916 new cases of LC were registered in the country (80.5% - in men and 19.5% - in women). During the studied years the average age of patients was 64.2±0.1 years (95%CI=63.9-64.4). The highest incidence rates per 100,000 in the entire population were found in the age groups 65-69 years (147.6±2.7), 70-74 years (159.3±2.5), and 75-79 years (147.1±3.2). The incidence of LC tended to increase only at the age of 80-84 years (APC=+1.26) and the most pronounced average annual decline rates were observed in the age groups of 45-49 years (APC=-4.09), 50-54 years (APC=-4.20) and 85+ years (APC=-4.07). The average annual standardized incidence rate was 22.2 per 100,000, and in dynamics tended to decrease (APC=-2.04). There is a decrease in incidence in almost all regions, with the exception of the Mangystau region (APC=+1.65). During the compilation of cartograms, incidence rates were determined on the basis of standardized indicators: low - up to 20.6, average - from 20.6 to 25.6, high - above 25.6 per 100,000 for the entire population. CONCLUSION: The incidence of lung cancer in Kazakhstan is decreasing. The incidence among the male population is six times higher than among the female, while the rate of decline is more pronounced. The incidence tends to decrease in almost all regions. High rates were found in the northern and eastern regions.

Two- and three-dimensional laparoscopic donor nephrectomy: a comparative study of a single-center experience.

Background: This is the first report on three-dimensional (3D) laparoscopic donor nephrectomy performed in the Central Asian region and Commonwealth of Independent States countries. This study presents the results of our initial experiences of 3D hand-assisted laparoscopic donor nephrectomy (3D-HALDN) in comparison with the outcomes of two-dimensional hand-assisted laparoscopic donor nephrectomy (2D-HALDN) at a single center. Methods: From 2015 to 2019, 19 3D-HALDN and 19 2D-HALDN procedures were performed at the same center by two surgeons. All 38 procedures used identical techniques. Between-group differences were considered statistically significant at P<0.05. Results: The baseline characteristics in both groups were statistically comparable (P>0.05). All donors underwent left nephrectomy. Donors who underwent 3D-HALDN had better outcomes than those who underwent 2D-HALDN, as shown by a shorter warm ischemic time (P<0.05), a shorter operative time (P<0.05), and less blood loss (P<0.05). There were no conversions or major complications (according to the Clavien-Dindo classification) in either group. The average drainage duration and postoperative hospitalization were significantly shorter in the 3D-HALDN group (P<0.05). The between-group differences in the mean postoperative creatinine level and glomerular filtration rate were not significant. Conclusions: The 3D-HALDN approach is more beneficial than traditional 2D-HALDN by providing a shorter warm ischemic time, less blood loss, and shorter durations of drainage and postoperative hospitalization. Postoperative complications and the functional condition of the kidney in donors in the early and late postoperative periods did not depend on the type of laparoscopic donor nephrectomy.