[Long-term renal function in patients with renal-cell carcinoma treated surgically: comparison between radical and...

To compare the renal function (RF) in patients with renal-cell carcinoma (RCC) treated by radical (RN) or partial nephrectomy (PN) and to assess the impact of the two surgical techniques in the glomerular filtration rate (GFR).

We retrospectively analyzed the database of patients with renal tumors treated surgically. RF was assessed preoperatively and postoperatively and compared between both techniques. GFR was estimated using CKD-EPI formula. Statistical analysis included X2, Student's t and Friedman tests and a method of logistic regression (multivariate analysis).

223 patients with RCC, who underwent surgery between 1981 and 2010, had complete information. The mean follow-up was 67.6 +/- 49.6 months. There were no significant differences in baseline characteristics between the RN (n = 196) and PN (N = 27) groups. After 6 months a GFR < 60 mL/min/1.73 m2 was detected in 63% vs. 29% (p = 0.0007), after 12 months in 64% vs. 33% (p = 0.002) and after 60 months in 53% vs. 40% (p = 0.2) of the patients in RN and PN groups, respectively. The absolute decrease in GFR was 22% after RN and 17% after PN. In the multivariate analysis, preoperative GFR and type of surgery were associated with an impairment of RF after 6 and 12 months.

RN results in a more important impairment of RF after 6 and 12 months. At 60 months, patients treated with PN maintain a mean GFR > 60 mL/min/1.73 m2.