Partial versus radical nephrectomy in clinical T2 renal masses

Area of Science:

• Urology
• Nephrology
• Oncology

Background:

• cT2 renal masses pose treatment challenges.
• Partial nephrectomy (PN) and radical nephrectomy (RN) are surgical options.
• Outcomes for these larger masses require detailed comparison.

Purpose of the Study:

• Compare perioperative, renal function, and oncologic outcomes of PN versus RN for cT2 renal masses.
• Evaluate the safety and efficacy of PN for larger renal tumors.

Main Methods:

• Retrospective review of 72 PN and 379 RN cases (2000-2016) for cT2 renal masses.
• Propensity score adjustment (inverse probability weighting) for balanced group comparison.
• Comparison of complications, estimated glomerular filtration rate (eGFR), metastasis-free survival (MFS), and cancer-specific survival (CSS).

Main Results:

• No significant difference in overall or severe complications between PN and RN.
• Radical nephrectomy showed more pronounced decline in eGFR at 1 and 3 years post-surgery (P < 0.001).
• Higher proportion of RN patients had eGFR <60 mL/min/1.73 m² at 1 and 3 years (P < 0.01).
• No significant differences in overall, MFS, or CSS between PN and RN for renal cell carcinoma patients.

Conclusions:

• Partial nephrectomy is a safe and effective treatment for cT2 renal masses.
• PN offers superior renal functional preservation compared to RN.
• PN should be considered for appropriately selected renal masses >7 cm.