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Renal volume matters: Assessing the association between excisional volume loss and renal function after partial
Gu-Shun Lai1, Sheng-Chun Hung2, Li-Wen Chang1
1Division of Urology, Department of Surgery, Taichung Veterans General Hospital, Taichung, Taiwan.
Asian Journal of Surgery
|July 21, 2019
Summary
Partial nephrectomy for clinical stage T1 renal cell carcinoma (RCC) shows comparable outcomes for T1a and T1b tumors. Preoperative kidney function predicts chronic kidney disease (CKD), and excisional volume loss impacts renal function post-surgery.
Area of Science:
- Urology
- Nephrology
- Oncology
Background:
- Partial nephrectomy is a standard treatment for clinical stage T1 (cT1) renal cell carcinoma (RCC).
- Assessing oncological and functional outcomes is crucial for patient management.
- Understanding factors influencing postoperative renal function is essential.
Purpose of the Study:
- To evaluate oncological and functional results after partial nephrectomy for cT1 RCC.
- To determine the association between excisional volume loss (EVL) and postoperative renal function.
- To identify risk factors for chronic kidney disease (CKD) post-surgery.
Main Methods:
- Retrospective review of 150 patients with cT1 RCC undergoing partial nephrectomy (2002-2016).
- Evaluation of recurrence-free survival (RFS), overall survival (OS), and development of stage III/IV CKD.
- Regression models and Spearman correlation used to analyze risk factors and EVL impact on renal function.
Main Results:
- No significant differences in RFS, OS, or CKD risk between cT1a and cT1b tumor groups.
- Preoperative estimated glomerular filtration rate (eGFR) is an independent predictor of stage III and IV CKD.
- Excisional volume loss (EVL) significantly correlates with decreased postoperative eGFR.
Conclusions:
- Partial nephrectomy yields comparable oncological and functional outcomes for cT1a and cT1b RCC.
- Preoperative eGFR is a key factor in predicting postoperative CKD.
- EVL influences the degree of renal function decline after partial nephrectomy.
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