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Open partial nephrectomy: outcomes from two UK centres.

Eleanor R Ray1, Benjamin W Turney, Rajinder Singh

  • 1Department of Pathology, Guy's Hospital, London, UK.

BJU International
|May 12, 2006
PubMed
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Open partial nephrectomy (OPN) offers good short-term cancer control and preserves kidney function, even outside specialized centers. This complex surgery provides achievable outcomes for kidney tumors, serving as a benchmark for new treatments.

Area of Science:

  • Urology
  • Oncology
  • Nephrology

Background:

  • Open partial nephrectomy (OPN) is a treatment for small kidney tumors.
  • Published data on OPN effectiveness is limited, often from highly specialized centers.
  • New kidney cancer treatments are increasingly advocated.

Purpose of the Study:

  • To define achievable outcomes of OPN in the UK.
  • To establish a benchmark for comparing new kidney cancer treatments.

Main Methods:

  • Retrospective review of 100 consecutive planned OPNs in 90 patients across two UK centers.
  • Analysis of operations for suspected cancer, imperative indications (single kidney, bilateral tumors, renal impairment), elective cases, and Von Hippel-Lindau (VHL) disease.
  • Inclusion of tumor size, ischemia times, complication rates, renal function preservation, and histopathology data.

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Main Results:

  • 95 OPNs were completed successfully; 5 required conversion to nephrectomy or were abandoned.
  • Intraoperative complication rate was 36% (11% major), higher in imperative/VHL cases (59% vs 12%).
  • Renal function was preserved in 80% of cases; 82% of specimens confirmed malignancy. Short-term cancer control was good, with no cancer deaths at median 24-month follow-up.

Conclusions:

  • OPN is complex but yields good results outside world-renowned centers.
  • It offers short-term cancer control with low renal morbidity.
  • Results serve as a UK reference point for evaluating new kidney cancer treatments.