Radical nephrectomy vs. partial nephrectomy in T1-2, N0, M0 cystic renal cell carcinoma
Marco Braaten1, Bob Weng1, Reid Morrissey1
1Creighton University Department of Internal Medicine, CHI Health Bergan Mercy Hospital, Omaha, Nebraska, USA.
Background:
Evaluate survival outcomes of PN compared to RN in patients with T1-2, N0, M0 cRCC.
Methods:
Patients with cRCC were identified using the National Cancer Database (NCDB). Inclusion criteria included T1-2, N0, M0 disease, treatment with either PN or RN, and a Charleston Deyo co-morbidity score of 0. Patients with missing survival data, advanced staging, or incomplete surgical information were excluded. Propensity score matching was performed to create identical groups with respect to age, sex, and race. Kaplan-Meier survival curves, multinomial logistic regression, and cox proportional hazard models were used for statistical analysis.
Results:
Of the 476 eligible propensity matched patients, 238 (50.0%) underwent PN and 238 (50.0%) underwent RN. PN was associated with better survival (mean: 186 vs. 170 months, P < 0.05) and lower odds of death (OR = 3.43; 95% CI, 2.05-5.76; P < 0.05). Five- and ten-year survival rates for PN were 95.2% and 91.1%, compared to 87.4% and 76.0% for RN. Patients treated with PN were significantly more likely to come from a higher income quartile and be treated at an academic/research facility.
Conclusion:
Partial nephrectomy demonstrates superior survival and shorter hospital stays compared to radical nephrectomy in localized cRCC, reinforcing its role as the preferred surgical approach.
