Functional and oncological outcomes of renal surgery for hilar tumors: Informing the decisions in risk-adapted management Journal Article

Authors: Alvim, R. G.; Tin, A. L.; Nogueira, L.; Wong, N. C.; Fonseca, R. C.; Sjoberg, D. D.; Hakimi, A. A.; Touijer, K. A.; Russo, P.; Coleman, J. A.
Article Title: Functional and oncological outcomes of renal surgery for hilar tumors: Informing the decisions in risk-adapted management
Abstract: Objective: To describe the safety and efficacy of partial nephrectomy (PN) in comparison to radical nephrectomy (RN) for surgically managed renal hilar tumors. Materials and Methods: We retrospectively reviewed institutional records of patients with a small (<5 cm) solitary renal (hilar or non-hilar) mass who underwent PN or RN between 2008 and 2018. Hilar tumors were defined as those at medial position, abutting the renal vessels. Recurrence-free, cancer-specific, and overall survival were estimated using the Kaplan-Meier method. Results: Of 1,951 eligible patients, 399 had hilar tumors (292 scheduled for PN, 107 RN) and 1,552 had non-hilar tumors (scheduled for PN). We found no significant differences in survival measures between hilar and non-hilar tumors in patients selected for PN. Patients scheduled for PN for hilar tumors had higher rates of ≥grade II postoperative surgical complications compared to patients scheduled to receive PN for non-hilar tumors (13% vs 8.6%; log-rank P =.018) and non-statistically significantly elevated rates of ≥grade II complications compared to patients scheduled for RN for hilar tumors (13% vs 6.5%; difference 6%, 95% CI 0.4%, 13%; log-rank P =.07). Conclusion: PN for hilar and non-hilar renal masses (<5cm) experience comparable oncologic outcomes though increased risk of complications for hilar masses. PN for hilar tumors was associated with better renal function and overall survival with non-statistically elevated risk of grade II or higher complications than RN. A renal tumor located at the hilum should not be a contra-indication for performing PN. © 2021 Elsevier Inc.
Keywords: adult; aged; major clinical study; overall survival; comparative study; medical decision making; retrospective study; risk assessment; postoperative complication; length of stay; partial nephrectomy; radical nephrectomy; kidney tumor; kidney function; kidney surgery; cancer specific survival; operation duration; clinical effectiveness; recurrence free survival; kidney blood vessel; human; male; female; article
Journal Title: Urology
Volume: 157
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2021-11-01
Start Page: 174
End Page: 180
Language: English
DOI: 10.1016/j.urology.2021.07.014
PUBMED: 34331997
PROVIDER: scopus
PMCID: PMC8671208
Notes: Article -- Export Date: 3 January 2022 -- Source: Scopus
Citation Impact
MSK Authors
  1. Jonathan Coleman
    306 Coleman
  2. Paul Russo
    561 Russo
  3. Karim Abdelkrim Touijer
    244 Touijer
  4. Daniel D. Sjoberg
    226 Sjoberg
  5. Abraham Ari Hakimi
    287 Hakimi
  6. Amy Lam Ling Tin
    95 Tin
  7. Ricardo Goncalves Alvim
    24 Alvim
  8. Nathan Colin Wong
    24 Wong