Outcomes following partial nephrectomy by tumor size
Paul L Crispen1, Stephen A Boorjian, Christine M Lohse
1Department of Urology, Mayo Clinic, Rochester, Minnesota 55905, USA.
The Journal of Urology
|September 20, 2008
Summary
Partial nephrectomy for renal tumors 7 cm or less offers durable cancer control. Tumor size is a key prognostic factor, especially when pathological evaluation is limited, aiding comparisons with other therapies.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Pathological evaluation of renal tumors is often limited.
- Renal tumor size is frequently the sole prognostic indicator available for ablative and observational therapies.
Purpose of the Study:
- To establish long-term survival rates in patients after partial nephrectomy for renal tumors.
- To analyze survival outcomes stratified by tumor size.
Main Methods:
- Retrospective review of a nephrectomy registry (1970-2004).
- Inclusion of patients with localized solid renal tumors ≤7 cm.
- Kaplan-Meier survival analysis for overall, cancer-specific, metastasis-free, and recurrence-free survival, stratified by tumor size.
Main Results:
- 798 patients underwent partial nephrectomy for renal tumors ≤7 cm.
- Renal cell carcinoma was diagnosed in 80% of cases.
- Survival outcomes significantly decreased with each 1 cm increase in tumor size (p <0.05) for all tumors and for renal cell carcinoma.
Conclusions:
- Partial nephrectomy provides durable cancer control for renal tumors ≤7 cm.
- Tumor size is a valuable prognostic index, particularly when full pathological evaluation is unavailable.
- Findings can inform comparisons with ablative and observational treatment outcomes.
Related Concept Videos
01:26Kidney Transplant II: Surgical Procedure
Preoperative ManagementThe primary goals of preoperative management in kidney transplantation are to optimize the patient’s metabolic state and prepare them for surgery through diet adjustments, necessary dialysis, and tailored medical treatment. This phase also involves comprehensive infection screening and patient education about the surgical procedure and postoperative care to improve outcomes and adherence.Medical ManagementA comprehensive evaluation is required for both the living donor...
01:16Kidney Transplant III: Nursing Management
Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...