A comparison of oncologic and functional outcomes in patients with pt3a renal cell carcinoma treated with partial and radical nephrectomy Journal Article


Authors: Alvim, R.; Tin, A.; Nogueira, L.; Lebdai, S.; Wong, N.; Takeda, T.; Assel, M.; Hakimi, A. A.; Touijer, K.; Russo, P.; Coleman, J.
Article Title: A comparison of oncologic and functional outcomes in patients with pt3a renal cell carcinoma treated with partial and radical nephrectomy
Abstract: HYPOTHESIS: Partial Nephrectomy is oncological safe in patients with pT3a RCC. PURPOSE: To compare the oncological and functional outcomes of patients with pT3a RCC scheduled for PN and RN. MATERIALS AND METHODS: We retrospectively reviewed patients with pT3a N0 M0 RCC who underwent partial or radical nephrectomy from 2005 to 2016. Perioperative characteristics, including estimated glomerular filtration rate, tumor size, pathological histology, and RENAL nephrometry score, were compared between patients scheduled for partial or radical nephrectomy. We used multivariable Cox proportional hazards regression models to compare overall survival, cancer-specific survival, and recurrence-free survival between planned procedure type. RESULTS: Of the 589 patients, 369 (63%) and 220 (37%) were scheduled for radical and partial nephrectomy, respectively; 26 (12%) of the scheduled partial nephrectomy cases were intraoperatively converted to radical nephrectomy. After adjusting for tumor size and histology, there were no statistically significant differences in overall survival (hazard ratio 0.66; 95% CI, 0.38-1.13), cancer-specific survival (hazard ratio 0.53; 95% CI, 0.16-1.75), or recurrence-free survival (hazard ratio 0.66; 95% CI, 0.34-1.28) between patients scheduled for partial or radical nephrectomy. Fewer patients scheduled for partial nephrectomy had estimated glomerular filtration rate reductions 3 to 9 months after surgery than patients scheduled for radical nephrectomy. CONCLUSION: We found no evidence that patients scheduled to undergo partial nephrectomy had poorer oncologic outcomes than patients scheduled to undergo radical nephrectomy. In select patients with pT3a renal cell carcinoma in whom partial nephrectomy is deemed feasible by the surgeon, partial nephrectomy should not be discouraged. Copyright® by the International Brazilian Journal of Urology.
Keywords: kidney neoplasms; nephrectomy; carcinoma, renal cell
Journal Title: International Brazilian Journal of Urology
Volume: 47
Issue: 4
ISSN: 1677-5538
Publisher: Sociedade Brasileira de Urologia  
Date Published: 2021-07-01
Start Page: 777
End Page: 783
Language: English
DOI: 10.1590/s1677-5538.Ibju.2020.0149
PUBMED: 33848068
PROVIDER: scopus
PMCID: PMC8321499
DOI/URL:
Notes: Article -- Export Date: 3 May 2021 -- Source: Scopus
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MSK Authors
  1. Jonathan Coleman
    343 Coleman
  2. Paul Russo
    581 Russo
  3. Karim Abdelkrim Touijer
    259 Touijer
  4. Abraham Ari Hakimi
    324 Hakimi
  5. Melissa Jean Assel
    110 Assel
  6. Amy Lam Ling Tin
    114 Tin
  7. Toshikazu   Takeda
    10 Takeda
  8. Souhil Lebdai
    5 Lebdai
  9. Ricardo Goncalves Alvim
    25 Alvim
  10. Nathan Colin Wong
    25 Wong