Partial nephrectomy for renal masses ≥ 7 cm: technical, oncological and functional outcomes.
Christopher J Long1, Daniel J Canter, Alexander Kutikov
1Department of Urologic Oncology Biostatistics, Fox Chase Cancer Center, Philadelphia, PA, USA.
BJU International
|January 7, 2012
Summary
Partial nephrectomy (PN) is a safe surgical option for large renal masses (≥ 7 cm), offering acceptable oncological, technical, and functional outcomes. This approach should be considered regardless of tumor size when feasible.
Area of Science:
- Urology
- Oncology
- Surgical Innovation
Background:
- Partial nephrectomy (PN) for pT1 renal masses shows good oncological outcomes and improved survival compared to radical nephrectomy.
- Previous data on PN for lesions ≥ 7 cm have yielded mixed results regarding oncological outcomes and technical success.
Purpose of the Study:
- To evaluate the outcomes of partial nephrectomy (PN) for renal masses ≥ 7 cm at our institution.
- To synthesize the cumulative published experience of PN for large renal masses.
Main Methods:
- Retrospective review of a prospectively maintained institutional kidney cancer database.
- Identification of patients undergoing PN for tumors >7 cm.
- Analysis of technical, oncological, and renal functional data, compared with existing literature.
Main Results:
- 46 patients with 49 renal tumors >7 cm underwent PN.
- Median follow-up was 13.1 months; 16 complications occurred (8.2% blood transfusions, 12.2% urinary fistulae).
- 5- and 10-year overall survival was 94.5%, and RCC-specific survival was 70.9%; 10.9% experienced CKD progression. Published data show comparable oncological outcomes and better renal function preservation with PN for large tumors.
Conclusions:
- Partial nephrectomy (PN) is a safe procedure for tumors ≥ 7 cm.
- PN demonstrates acceptable technical, oncological, and functional outcomes for large renal masses.
- Further research is recommended to solidify these findings.
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