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

A Chebbi1, T Benoit2, A Giwerc1

  • 1Service d'urologie, CHU de Rouen, 1, rue de Germont, 76031 Rouen cedex, France.

Progres En Urologie : Journal De L'Association Francaise D'Urologie Et De La Societe Francaise D'Urologie
|February 6, 2017
PubMed
Summary
This summary is machine-generated.

Partial nephrectomy (PN) is feasible for large renal tumors (>7cm), but carries a higher risk of complications. Careful patient selection is crucial for successful outcomes in these cases.

Keywords:
Morbidité périopératoiresNéphrectomie partielleNéphrectomie élargiePartial nephrectomyRadical nephrectomySurgical mobiditySurvieSurvivalTaille tumoraleTumor size

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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.