[Imperative partial nephrectomy for renal cell carcinoma: oncological and functional results]
A Lecouteux1, J Rigaud, P Glemain
1Clinique urologique, CHU de Nantes, place Alexis-Ricordeau, Nantes, France. adrien.lecouteux@gmail.com
Summary
Partial nephrectomy for renal cell carcinoma preserves kidney function but carries significant risks of morbidity and recurrence. This study evaluated oncological and functional outcomes in imperative cases.
Area of Science:
- Nephrology
- Urologic Oncology
- Surgical Oncology
Context:
- Renal cell carcinoma (RCC) treatment often necessitates kidney-sparing approaches.
- Partial nephrectomy (PN) is a standard for localized RCC, but imperative indications require careful risk-benefit assessment.
Purpose:
- To evaluate the oncological and functional outcomes of partial nephrectomy performed under imperative indications for renal cell carcinoma.
- To assess the morbidity and recurrence rates associated with this surgical approach.
Summary:
- A retrospective study of 61 patients (65 PNs) for imperative indication RCC between 1990-2009.
- Mean follow-up was 47.4 months; 87.5% of tumors were asymptomatic with an average diameter of 4.3 cm.
- Postoperative renal function showed a significant decline (creatinine P=0.0003, clearance P=0.0002). Morbidity was 38.5%, with a 29% recurrence rate.
Impact:
- Partial nephrectomy in imperative indications preserves renal function but is associated with considerable morbidity and recurrence rates.
- Long-term survival rates at 1, 3, 5, and 10 years were 98.4%, 91.2%, 91.2%, and 51.9%, respectively.
- Findings highlight the trade-offs between renal preservation and surgical risks in managing complex renal cell carcinoma cases.
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