Partial nephrectomy for T3aN0M0 renal cell carcinoma: shall we step forward?

Vol. 43 (5): 849-856, September – October, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0598


ORIGINAL ARTICLE

Ding Peng 1, Zhi-song He 1, Xue-song Li 1, Qi Tang 1, Lei Zhang 1, Kai-wei Yang 1, Xiao-teng Yu 1, Cui-jian Zhang 1, Li-qun Zhou 1
1 Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

ABSTRACT

Objectives: To evaluate the prognosis of non-metastatic T3a renal cell carcinoma (RCC) with partial nephrectomy (PN).

Patients and Methods: We retrospectively evaluated 125 patients with non-metastatic T3a RCC. Patients undergoing PN and radical nephrectomy (RN) were strictly matched by clinic-pathologic characteristics. Log-rank test and Cox regression model were used for univariate and multivariate analysis.

Results: 18 pair patients were matched and the median follow-up was 35.5 (10-86) months. PN patients had a higher postoperative eGFR than RN patients (P=0.034). Cancer-specific survival (CSS) and recurrence-free survival (RFS) did not differ be­tween two groups (P=0.305 and P=0.524). On multivariate analysis, CSS decreased with positive surgical margin and anemia (both P <0.01) and RFS decreased with Furh­man grade, positive surgical margin, and anemia (all P<0.01).

Conclusions: For patients with non-metastatic pT3a RCC, PN may be a possible option for similar oncology outcomes and better renal function.

Keywords: Carcinoma, Renal Cell; Nephrectomy; Patients

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