Partial versus Radical Nephrectomy for clinically organ confined clear cell RCC
Introduction & Objective:
Partial Nephrectomy (PN) has become a standard of treatment for cT1 renal tumors. However, few studies compared the oncologic outcomes of PN and radical nephrectomy (RN) for pT2-3a clear cell renal cell carcinoma (cc-RCC). In this study we compared cancer-specific survival (CSS) of PN and RN performed in patients with pT1-pT3a-pNx cc-RCC.
Materials and Methods:
Data were prospectively collected in an institutional “renal surgery” database from 2001 to 2013. Out of 1650 cases, 921 were cc-RCC and 654 patients met inclusion criteria (cT<3-cN0-cM0 and pT1a-pT3a-pNx), 252 of which treated with RN and 402 with PN. A stage specific analysis comparison of oncologic outcomes between PN and RN was performed. Results: Patients treated with RN had larger tumors (p<0.001), higher pT stages (p<0.001) and higher incidences of Fuhrman G3-4 (p=0.004) (Table 1). At log rank test CSS was not different between PN and RN group (p=0.926; Figure 1). After stratifying for pT substages PN and RN groups displayed comparable CSS for pT1 (p=0.554) as well as for pT2-3a cc-RCC (p=0.398) (Figure 2). Similarly, both for Fuhrman grade 1-2 and for grade 3-4 cc-RCC, PN did not undermine CSS probability (p=0.991 and p=0.734, respectively). Conclusions: CSS probabilities for cT<3-N0-M0 cc-RCC were not dependent on surgical approach. PN is an oncologically effective approach also for pT2 and pT3a cc-RCC. ==fine abstract==