Partial Nephrectomy for T1b/T2 Renal Mass: An Added Shift from Radical Nephrectomy.

Area of Science:

• Urology
• Nephrology
• Oncology

Background:

• Large renal masses (>4 cm) present management challenges.
• Partial nephrectomy (PN) is a standard treatment for renal tumors.
• Assessing PN outcomes for larger masses is crucial.

Purpose of the Study:

• To evaluate the short-term outcomes of partial nephrectomy (PN) for large renal masses (>4 cm).
• To assess the safety, efficacy, and impact on renal function of PN in this cohort.

Main Methods:

• Retrospective analysis of 47 patients undergoing PN for renal masses >4 cm over 3 years.
• Data collected included demographics, tumor characteristics (size, complexity via nephrometry score), surgical parameters (time, complications), and pre/postoperative estimated glomerular filtration rate (eGFR).
• Cancer recurrence and renal function changes were monitored during follow-up.

Main Results:

• 47 patients (mean age 55.7 years, 29 males) with mean tumor size 6.2 cm underwent PN.
• Renal cell carcinoma (RCC) was present in 42 patients; 12% had pathological T3 RCC.
• No significant difference in pre- and postoperative eGFR (89.09 vs 88.50, P=0.2) was observed.
• Median follow-up was 14 months with no evidence of cancer recurrence.

Conclusions:

• Partial nephrectomy for large renal masses (>4 cm) is a safe and feasible procedure in experienced hands.
• PN can be considered for a higher percentage of patients with large renal masses, irrespective of complexity.
• Short-term results indicate preserved renal function and no recurrence, warranting further long-term investigation.