Outcome of Stage T2 or Greater Renal Cell Cancer Treated With Partial Nephrectomy (original) (raw)
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International Journal of Urology, 2014
To compare the recurrence-free survival of partial nephrectomy and radical nephrectomy in patients with non-metastatic pathological T3a renal cell carcinoma. We reviewed the records of 3567 patients who had undergone a nephrectomy for renal cell carcinoma at five institutions in Korea from January 2000 to December 2010. The clinical data of 45 patients with pathological T3a renal cell carcinoma in the partial nephrectomy group were compared with 298 patients with pathological T3a renal cell carcinoma in the radical nephrectomy group. The effects of surgical methods on recurrence-free survival were assessed by a multivariate Cox proportional hazard analysis. All comparisons were repeated in subgroup analysis on 63 clinical T1a patients with tumors ≤4 cm. During a median 43-month follow-up period, disease recurrence occurred in two patients (4.4%) in the partial nephrectomy group, and 94 patients (31.5%) in the radical nephrectomy group. The results from a multivariate model showed that radical nephrectomy was a significant predictor of recurrence. However, in subgroup analysis that included 63 clinical T1a pathological T3a patients, the recurrence-free survival rates were not significantly different between the two cohorts. The renal function was significantly better preserved in the partial nephrectomy cohort than in the radical nephrectomy cohort. Partial nephrectomy provides similar recurrence-free survival outcomes compared with radical nephrectomy in patients with clinical T1a pathological T3a renal cell carcinoma. However, there seems to be a higher risk of recurrence for large pathological T3a tumors treated by radical nephrectomy compared with small tumors treated by partial nephrectomy. Thus, large tumors with the same pathological T3a renal cell carcinoma grade could have hidden aggressive features.
2020
Radical Nephrectomy is the gold standard surgical approach for T3a Renal Cell Carcinomas. However, a small but not insignificant number of patients pre-operatively staged cT1/cT2 are treated with a partial nephrectomy but at final pathology are subsequently upstaged to pT3a. Renal cell carcinoma (RCC) is a kidney malignant growth that begins in the covering of the proximal tangled tubule, a piece of the exceptionally little cylinders in the kidney that transport essential pee. RCC is the most widely recognized sort of kidney malignancy in grown-ups, liable for roughly 90–95% of cases.RCC event shows a male predomiance over ladies with a proportion of 1.5:1. RCC most normally happens somewhere in the range of sixth and seventh decade of life.
Urologic oncology, 2017
Although partial nephrectomy (PN) is the standard treatment for localized clinical T1a renal cell carcinoma (RCC), treatment of larger renal tumors is controversial. We evaluated the oncological outcomes and perioperative complications after radical and PN for RCC ≥4cm. We retrospectively analyzed the data of 2,373 patients surgically treated for nonmetastatic RCC with clinical T1b or T2 (≥4cm). The propensity scores for surgery type were calculated, and the partial group was matched to the radical group in a 1:3 ratio. The oncological outcomes were compared using Kaplan-Meier analysis and multivariate Cox regression models were used to identify the independent predictors of progression-free, cancer-specific, and overall survival. All differences in preoperative clinical characteristics disappeared after matching. There were no significant differences in progression-free, cancer-specific, or overall survival between the partial and radical groups in the matched cohort. The patients&...
Public Health of Indonesia, 2018
Background: Renal cell carcinoma accounts for 85% of all solid tumors of the kidney. For many years, radical nephrectomy was the standard treatment for RCC. Partial nephrectomy has gradually replaced radical nephrectomy over the past decade, especially for T1 stage renal cell carcinoma. However, the benefit of partial nephrectomy on oncologic outcomes is not well known.Objective: to investigate the clinical outcome of partial nephrectomy on T1 renal cell carcinoma. Methods: This prospective observational study was conducted in a single unit of urology department of Dhaka Medical College Hospital, Bangladesh from the period September 2014 to September 2017. Fourteen patients underwent partial nephrectomy during this period with renal mass based on eligibility criteria. Two follow up was done at three months and six months. Result: Mean age of the patients undergoing surgery was 52.0± 3.8 (46.0 to 57.0 years) years. For the majority of the patients, tumour size was in a range of 3...
Journal of the Chinese Medical Association, 2007
Background: Partial nephrectomy has been considered an effective and efficient method in the treatment of localized renal cell carcinoma. Herein, we retrospectively review our experience with partial nephrectomy in the treatment of localized renal cell carcinoma and compared it with patients who received radical nephrectomy. Methods: From 1982 to 2005, 35 patients who received partial nephrectomy for localized renal cell carcinoma were enrolled in this study. Ten patients were female (28.6%). The median age was 70 years (range, 42-82 years). Sixteen (45.7%) patients had pathologic T1a tumors; 17 (48.6%) patients had pathologic T1b tumors and 2 (5.7%) patients had pathologic T2 tumor (7 cm). In the meantime, 128 patients who had T1N0M0 renal cell carcinoma and who received radical nephrectomy were assigned to a control group. Thirty-nine patients (30.5%) were female in this group. The median age was 62 years (range, 30-83 years). The tumor characteristics, location, surgical techniques and patient survival were subsequently compared. Results: The median tumor size in the partial nephrectomy group was 3.9 cm (range, 1.5-7.0 cm), and it was 4.5 cm (range, 1-6.5 cm) in radical nephrectomy group. The tumor size was smaller in the partial nephrectomy group (p = 0.003). The median follow-up period was 4.38 years (range, 0.05-17.99 years) in the partial nephrectomy group and 5.66 years (range, 0.01-22.25 years) in the radical nephrectomy group. There was no local recurrence or distant metastasis in the partial nephrectomy group. The 5-year overall survival was 85.0% compared with 91.4% in the radical nephrectomy group (p = 0.126). The 5-year disease-specific survival in the partial nephrectomy group was 100%. The postoperative serum creatinine level increased to > 2.0 mg/dL in 5 (14.3%) patients in the partial nephrectomy group, but no patient needed hemodialysis during follow-up. Conclusion: From our review, partial nephrectomy is safe and provides excellent disease control in the treatment of localized renal cell carcinoma in selected patients. Renal function preservation was observed in the partial nephrectomy group, while the operated kidney showed functioning in the follow-up nuclear medicine survey. [J Chin Med Assoc 2007;70 : [281][282][283][284][285]
Comparison of Partial and Radical Nephrectomy for pT1b Renal Cell Carcinoma
Korean journal of urology, 2010
Partial nephrectomy (PN) for patients with T1a renal cell carcinoma (RCC) has increasingly become accepted, although its role for patients with T1b RCC remains controversial. We retrospectively evaluated and then compared the oncologic and functional outcomes of patients with pT1b RCC who were treated with PN or radical nephrectomy (RN). A total of 70 patients who were diagnosed with pT1bN0M0 RCC between January 1995 and December 2004 were included. The 5-year overall survival (OS), the 5-year recurrence-free survival (RFS), and the 5-year cancer-specific survival (CSS) were compared between the groups. Preoperative and postoperative serum creatinine and estimated glomerular filtration rate (GFR) levels were analyzed to assess renal function. The 5-year OS (92.3% vs. 87.8%, p=0.501), RFS (92.3% vs. 77.8%, p=0.175), and CSS (92.3% vs. 94.5%, p=0.936) of the PN and RN groups were not statistically different. The proportion of patients with decreased renal function was lower in the PN ...
Partial nephrectomy: alternative treatment for selected patients with renal cell carcinoma
Urology, 1998
Objectives. To analyze the experience and the results of partial nephrectomy in a single institution over the last 10 years in order to optimize patient selection and minimize morbidity.Methods. This is a retrospective chart review of 64 patients (mean age 56.6 years, range 18 to 88; 43 men, 21 women) who underwent 66 partial nephrectomies at the Brigham and Women’s
Vojnosanitetski pregled, 2021
Background/Aim. In renal cell carcinoma (RCC), the choice of surgical technique, radical (RN) or partial nephrectomy (PN), is still center-dependent because there are still no absolute recommendations for this approach. The aim of this study was to analyze the oncological aspects, time until recurrent disease appears, and cancer-specific survival in patients with RCC in T1bN0?0 stadium depending on the type of surgical procedure, PN or RN technique. Methods. In a clinical observational study, data of 154 patients operated at the Clinic for Urology, Military Medical Academy, Belgrade, Serbia with a mean follow-up period of no less than five years were analyzed. Patients were divided into two groups; a group of patients with RN and a group of patients with PN. The inclusion criteria were: renal tumors 4?7 cm, histopathological confirmation of RCC, absence of metastasis, and normal serum creatinine. Exclusion criteria included: the presence of other malignancies, solitary functional ki...