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Published on: May 19, 2022
Oncological outcomes of nephron sparing nephrectomy. 17-year analysis
Alfredo Aguilera Bazan1, B Bañuelos, J M Alonso-Dorrego
1Servicio de Urologia. Hospital Universitario La Paz. Madrid .Spain.
Objectives:
Nephron sparing renal surgery is considered the technique of choice for renal tumors smaller than 4 cm. We present our oncological results in a 17-year period.
Methods:
Between January 1995 and December 2012, 130 renal tumor surgeries (58 open, 72 laparoscopic) were performed. We analize the pathological results, presence of positive surgical margins, local relapse, distant metastases and death.
Results:
The most frequent tumor was clear cell carcinoma (73%) in a pT1 stage (87%). Mean tumor size was 3 cm. Positive surgical margin rate was 7%, currently without any tumor recurrence among these cases (follow up 37 months). Cancer specific mortality is 0% and local recurrence rate 3%. Mean follow up is 71 months.
Conclusions:
Nephron sparing surgery results are similar to radical nephrectomy in tumors smaller than 4 cm. Positive surgical margins do not seem to have an important repercussion in cancer specific survival.
Insights
Nephron sparing surgery for small renal tumors (<4 cm) shows excellent oncological outcomes. Positive surgical margins did not significantly impact cancer-specific survival in this 17-year study.
Area of Science:
- Urology
- Oncology
- Nephrology
Background:
- Nephron sparing surgery is the standard for renal tumors <4 cm.
- Evaluating long-term oncological outcomes is crucial.
Purpose of the Study:
- To assess the oncological results of nephron sparing renal surgery over 17 years.
- To analyze recurrence and survival rates after nephron sparing surgery for small renal tumors.
Main Methods:
- Retrospective analysis of 130 renal tumor surgeries (open and laparoscopic) from 1995-2012.
- Evaluation of pathological results, surgical margins, local relapse, distant metastases, and mortality.
- Mean follow-up of 71 months.
Main Results:
- Clear cell carcinoma (73%) in pT1 stage (87%) were most common, with a mean tumor size of 3 cm.
- Positive surgical margin rate was 7%, with no recurrence in these cases (37-month follow-up).
- Cancer-specific mortality was 0% and local recurrence rate was 3%.
Conclusions:
- Nephron sparing surgery offers oncological results comparable to radical nephrectomy for renal tumors <4 cm.
- Positive surgical margins appear to have minimal impact on cancer-specific survival.
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