Background: The value of liver-directed therapy (LDT) in patients with metastasic renal cell carcinoma (MRCC) is still an active field of research, particularly in the era of tyrosinkinase inhibitor (TKI) therapy. Methods: The records of 35 patients with MRCC undergoing LDT of metastasic liver lesions between 1992 and 2015 were retrospectively analyzed. Immediate postoperative TKI was given in a subgroup of patients after LDT for metastasic lesions. Uni- and multivariate models were applied to assess overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS). Results: Following primary tumor (renal cell cancer) resection and LDT, respectively, median OS was better for a total of 16 patients (41 %) receiving immediate postoperative TKI with 151 and 98 months, when compared to patients without TKI therapy with 61 (p = 0.003) and 40 months (p = 0.032). Immediate postoperative TKI was associated with better median PFS (47 months versus 19 months; p = 0.023), whereas in DFS only a trend was observed (51 months versus 19 months; p = 0.110). Conclusions: LDT should be considered as a suitable additive tool in the era of TKI therapy of MRCC to the liver. In this context, postoperative TKI therapy seems to be associated with better OS and PFS, but not DFS.

The objective of the thesis: to evaluate patients’ who are ill with metastasic tumor of long bones (os longum) and have an X-ray – confirmed diagnose of pathological bone break comfort of living. Tasks for the research: 1. To examine patients’ who are ill with metastasic tumor of long bones and have an X-ray – confirmed diagnose of pathological bone break comfort of living, singularities of nursing and their change during the term of research. 2. To compare comfort of living and singularities of nursing of patients’ who are ill with metastasic tumor of long bones and have an X-ray – confirmed diagnose of pathological bone break with those of the control group. 3. To determine factors having impact on comfort of living and nursing of patients’ who are ill with metastasic tumor of long bones and have an X-ray – confirmed diagnose of pathological bone break. 4. To supply with the recommendations for development of nursing of the patients ill with metastasic tumor of long bones. Exploratory group – patients of Orthopedics and Trauma Clinics at the Kaunas University of Medicine Clinics ill with metastasic tumor of long bones and have an X-ray – confirmed diagnose of pathological bone break. Control group (control) - patients of Orthopedics and Trauma Clinics at the Kaunas University of Medicine Clinics suffering from analogous break of long bone but in absence of metastasic tumor of long bones. Results: After summing the collected data up and analyzing it a conclusion was drawn... [to full text]

Background: The value of liver-directed therapy (LDT) in patients with metastasic renal cell carcinoma (MRCC) is still an active field of research, particularly in the era of tyrosinkinase inhibitor (TKI) therapy. Methods: The records of 35 patients with MRCC undergoing LDT of metastasic liver lesions between 1992 and 2015 were retrospectively analyzed. Immediate postoperative TKI was given in a subgroup of patients after LDT for metastasic lesions. Uni- and multivariate models were applied to assess overall survival (OS), progression-free survival (PFS) and disease-free survival (DFS). Results: Following primary tumor (renal cell cancer) resection and LDT, respectively, median OS was better for a total of 16 patients (41 %) receiving immediate postoperative TKI with 151 and 98 months, when compared to patients without TKI therapy with 61 (p = 0.003) and 40 months (p = 0.032). Immediate postoperative TKI was associated with better median PFS (47 months versus 19 months; p = 0.023), whereas in DFS only a trend was observed (51 months versus 19 months; p = 0.110). Conclusions: LDT should be considered as a suitable additive tool in the era of TKI therapy of MRCC to the liver. In this context, postoperative TKI therapy seems to be associated with better OS and PFS, but not DFS.