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Long-term results of nephron sparing surgery for localized renal cell carcinoma: 10-year followup
A F Fergany1, K S Hafez, A C Novick
1Department of Urology, Cleveland Clinic Foundation, Ohio, USA.
Purpose:
Partial nephrectomy is effective for renal cell carcinoma when preservation of renal function is a concern. We present the 10-year followup of patients treated with nephron sparing surgery at our institution.
Materials And Methods:
Partial nephrectomy was performed in 107 patients with localized sporadic renal cell carcinoma before December 1988. Tumors were symptomatic in 73 patients (68%) and indications for surgery were imperative in 96 (90%). Of the patients 42 (39%) had renal insufficiency preoperatively. All patients were followed a minimum of 10 years or until death.
Results:
At the end of the followup interval 32 patients (30%) had no evidence of recurrence, 28 (26%) died of metastatic renal cell carcinoma and 46 (42%) died of unrelated causes. Cancer specific survival was 88.2% at 5 and 73% at 10 years, and was significantly affected by tumor stage, symptoms, tumor laterality and tumor size. Long-term renal function was stable in 52 patients (49%).
Conclusions:
Partial nephrectomy is effective for localized renal cell carcinoma, providing long-term tumor control with preservation of renal function.