Partial nephrectomy for patients with a solitary kidney: The Memorial Sloan-Kettering experience Journal Article
| Authors: | Saranchuk, J. W.; Touijer, A. K.; Hakimian, P.; Snyder, M. E.; Russo, P. |
| Article Title: | Partial nephrectomy for patients with a solitary kidney: The Memorial Sloan-Kettering experience |
| Abstract: | OBJECTIVE: To report the experience of partial nephrectomy in patients with a solitary kidney at one institution, with analysis of renal function, complications, oncological efficacy and survival. PATIENTS AND METHODS: We identified 54 consecutive patients with a solitary kidney who had a partial nephrectomy between December 1989 and July 2003. Variables examined included patient age and gender, renal function, renal ischaemia time, surgical margin status and complications. Pathological features, e.g. tumour size, histological subtype and tumour stage, were also assessed. Disease-free probability and overall and cancer-specific survivals were determined. RESULTS: The histological subtype was clear cell in 35 cases (65%), papillary in 10 (19%), oncocytoma in four (7%), chromophobe in two (4%), unclassified in one (2%) and multiple subtypes in two (2%). The median creatinine level before surgery was 14 mg/L, which increased to 16 mg/L 6 months afterward, and at 1 and 2 years after surgery it was 15 mg/L. Two patients developed endstage renal disease requiring haemodialysis, one soon after surgery and another 8 years after nephron-sparing surgery. In all, 26% of patients developed at least one perioperative complication, with acute renal failure and urinary fistula being the most common. At 5 years the overall and cancer-specific survival, and disease-free probability were 68%, 88% and 73%, respectively. CONCLUSIONS Partial nephrectomy is safe in patients with a solitary kidney, with an acceptable decline in renal function and low likelihood of requiring temporary or permanent haemodialysis. After an initial decline, renal function appears to stabilize during the first year. |
| Keywords: | adult; cancer survival; human tissue; treatment outcome; aged; aged, 80 and over; disease-free survival; middle aged; major clinical study; histopathology; cancer staging; outcome assessment; neoplasm recurrence, local; tumor volume; creatinine; creatinine blood level; kidney failure; oncocytoma; kidney carcinoma; kidney neoplasms; nephrectomy; postoperative complication; postoperative complications; partial nephrectomy; kidney function; kidney ischemia; kidney surgery; carcinoma; papilloma; clear cell carcinoma; hemodialysis; renal cell; solitary kidney; intraoperative complications; urinary tract fistula; nephron; kidney neoplasm; humans; human; male; female; priority journal; article |
| Journal Title: | BJU International |
| Volume: | 94 |
| Issue: | 9 |
| ISSN: | 1464-4096 |
| Publisher: | Wiley Blackwell |
| Date Published: | 2004-12-01 |
| Start Page: | 1323 |
| End Page: | 1328 |
| Language: | English |
| DOI: | 10.1111/j.1464-410X.2004.05165.x |
| PROVIDER: | scopus |
| PUBMED: | 15610114 |
| DOI/URL: | |
| Notes: | BJU Int. -- Cited By (since 1996):52 -- Export Date: 16 June 2014 -- CODEN: BJINF -- Source: Scopus |
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