Radical versus partial nephrectomy for T1 non-clear cell renal cell carcinoma
Xu Hu1, Yaohui Wang1, Yanxiang Shao1
1Institute of Urology, Department of Urology, West China Hospital, West China Medical School, Sichuan University, Chengdu, 610041, China.
Summary
Partial nephrectomy (PN) shows comparable survival outcomes to radical nephrectomy (RN) for T1 non-clear cell renal cell carcinoma (nccRCC). PN may be a preferred surgical option for nccRCC, warranting further investigation.
Area of Science:
- Urology
- Oncology
- Surgical Pathology
Background:
- Nephron-sparing surgery is standard for T1 renal cell carcinoma (RCC).
- Non-clear cell RCC (nccRCC) is a diverse group of kidney cancers.
- Surgical management of nccRCC requires careful consideration of histological subtypes.
Purpose of the Study:
- To compare the effectiveness of radical nephrectomy (RN) versus partial nephrectomy (PN) in patients with non-clear cell renal cell carcinoma (nccRCC).
- To evaluate survival outcomes, including overall survival (OS) and cancer-specific survival (CSS), for different surgical approaches in nccRCC.
Main Methods:
- Analysis of Surveillance, Epidemiology, and End Results (SEER) registry data from 2000-2019.
- Inclusion of 7575 patients diagnosed with nccRCC.
- Application of Kaplan-Meier survival analysis, log-rank tests, and multivariate Cox regression.
Main Results:
- Partial nephrectomy (PN) demonstrated significantly better overall survival (OS) and cancer-specific survival (CSS) compared to radical nephrectomy (RN) in the overall nccRCC cohort.
- Multivariate analysis confirmed RN as a predictor of poorer OS and CSS in nccRCC.
- Subgroup analysis indicated RN was associated with worse OS in papillary and chromophobe RCC, and worse CSS in papillary RCC.
Conclusions:
- For T1 non-clear cell renal cell carcinoma (nccRCC), partial nephrectomy (PN) is not inferior to radical nephrectomy (RN) in terms of overall survival (OS) and cancer-specific survival (CSS).
- PN may be the preferred surgical approach for T1 nccRCC.
- Further prospective studies are recommended to confirm these findings.
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