Tumor location does not affect long-term renal function after partial nephrectomy Journal Article

Authors: Pettus, J. A.; Sharp, D. S.; Yossepowitch, O.; Schacter, L. R.; Ferrandino, M. N.; Snyder, M. E.; Bach, A. M.; Russo, P.
Article Title: Tumor location does not affect long-term renal function after partial nephrectomy
Abstract: Objectives: To study the effect of central tumor location on the glomerular filtration rate (GFR) after partial nephrectomy for renal cortical tumor. Methods: We reviewed our institutional database to identify patients who had undergone partial nephrectomy from January 1995 to July 2005. Central tumors were defined as those encroaching on the collecting system or renal sinus or that did not distort the renal contour; all others were categorized as peripheral on preoperative abdominal imaging. We calculated the GFR preoperatively, during the hospital stay, and at 1 and 12 months after surgery. Linear regression models were fit to determine the association of tumor location with the changes in GFR at each period, after controlling for age, sex, operative and ischemic times, comorbidities, and blood loss. Results: A total of 248 central and 333 peripheral tumors were available for analysis. Patients with central tumors were younger than those with peripheral tumors (62 versus 59 years, P = 0.014) and experienced longer intraoperative renal ischemia times (40 versus 29 minutes, P <0.001) and longer operations (195 versus 179 minutes, P = 0.004). On multivariate analysis, tumor location was not significantly associated with the change in GFR at any of the intervals, after adjusting for the covariates. Conclusions: The results of our study have indicated that tumor location does not appear to affect long-term renal function. Thus, partial nephrectomy should not be withheld from this subset of patients. © 2007 Elsevier Inc. All rights reserved.
Keywords: adult; controlled study; human tissue; aged; middle aged; recovery of function; major clinical study; tumor localization; kidney neoplasms; nephrectomy; partial nephrectomy; kidney tumor; kidney function; kidney ischemia; warm ischemia; intraoperative period; operation duration; glomerular filtration rate; glomerulus filtration rate; multivariate analysis
Journal Title: Urology
Volume: 69
Issue: 6
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2007-06-01
Start Page: 1059
End Page: 1063
Language: English
DOI: 10.1016/j.urology.2007.02.058
PUBMED: 17572186
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 10" - "Export Date: 17 November 2011" - "CODEN: URGYA" - "Source: Scopus"
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MSK Authors
  1. Paul Russo
    457 Russo
  2. Ariadne Bach
    56 Bach
  3. Joseph Atkins Pettus
    16 Pettus
  4. David Scott Sharp
    9 Sharp
  5. Mark Snyder
    26 Snyder