[Partial nephrectomy vs. radical nephrectomy for tumor>7cm]

Area of Science:

• Urology
• Oncology
• Nephrology

Background:

• Partial nephrectomy (PN) is standard for small renal tumors (<7cm).
• Limited data exists for PN in larger renal tumors (≥T2).

Purpose of the Study:

• To evaluate the outcomes of PN for renal tumors greater than 7cm.
• Compare PN with radical nephrectomy (RN) for cT2 renal tumors.

Main Methods:

• Retrospective two-center study of 170 patients (32 PN, 138 RN) for cT2 tumors (2004-2014).
• Comparison of perioperative morbidity and survival rates between PN and RN groups.

Main Results:

• PN group had higher perioperative complications (50.0% vs. 18.1%, P=0.008) and more severe complications (Clavien≥3: 18.7% vs. 5.1%, P=0.01).
• RN group showed a greater initial decrease in creatinine clearance (-24.3mL/min vs. -16.8mL/min, P=0.04), which normalized by follow-up.
• No significant difference in overall survival was observed between groups.
• Positive surgical margins were more frequent in the PN group (9.1% vs. 0.85%, P=0.01).

Conclusions:

• PN is a feasible option for renal tumors >7cm.
• PN for large renal tumors is associated with increased perioperative complications.
• Careful patient selection is essential for considering PN in cases of large renal tumors.