PROGRESSION AND LONG-TERM SURVIVAL AFTER SIMPLE ENUCLEATION FOR THE ELECTIVE TREATMENT OF RENAL CELL CARCINOMA: EXPERIENCE IN 107 PATIENTS
- 1 July 2005
- journal article
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Urology
- Vol. 174 (1), 57-59
- https://doi.org/10.1097/01.ju.0000162019.45820.53
Abstract
Purpose: We present our findings in a series of T1a renal cell carcinoma treated with elective simple enucleation, specifically reporting the incidence of local recurrence, and progression-free and disease specific survival rates. Materials and Methods: A total of 107 patients who underwent elective nephron sparing surgery performed with simple enucleation from January 1989 to December 2000 were studied retrospectively. None of the patients had preoperative or intraoperative suspicion of positive nodes. All patients were free from distant metastases before surgery (M0). Patient status was last evaluated in July 2004. Mean (median, range) followup was 88.3 (84, 44 to 175) months. Results: Pathological review according to the 2002 TNM classification showed that 95% (102 of 107) of tumors were pT1a, 4% (4 of 107) pT1b and 1% (1 of 107) pT3a. Mean (SD, median, range) tumor greatest dimension was 2.7 (0.93, 2.5, 0.6 to 5) cm. None of the patients died in the immediate postoperative period (within the first 30 days). There were no major complications such as bleeding and urinary leakage/urinoma requiring reoperation. The 5 and 10-year cancer specific survival was 99% and 97.8%, respectively. The 5 and 10-year progression-free survival was 98.1% and 94.7%, respectively. Overall 3 patients had disease progression (2.8%) of whom 2 (1.9%) were local recurrence, 1 alone and 1 associated with distant metastases diagnosed 12 months earlier. Conclusions: Simple tumor enucleation is a safe and acceptable approach for elective nephron sparing surgery. It provides excellent long-term progression-free and cancer specific survival rates, and is not associated with an increased risk of local recurrence compared with partial nephrectomy.Keywords
This publication has 16 references indexed in Scilit:
- Long-term survival of patients with unilateral sporadic multifocal renal cell carcinoma according to histologic subtype compared with patients with solitary tumors after radical nephrectomyUrology, 2004
- Nephron-sparing surgery for renal cell carcinoma: clinicopathologic features predictive of patient outcomeUrology, 2003
- Optimal Margin in Nephron-Sparing Surgery for Renal Cell Carcinoma 4 cm or LessEuropean Urology, 2003
- Prognostic importance of resection margin width after nephron-sparing surgery for renal cell carcinomaUrology, 2002
- DOES THE SIZE OF THE SURGICAL MARGIN IN PARTIAL NEPHRECTOMY FOR RENAL CELL CANCER REALLY MATTER?Journal of Urology, 2002
- Is a 1-cm margin necessary during nephron-sparing surgery for renal cell carcinoma?Urology, 2001
- NEPHRON SPARING SURGERY FOR RENAL TUMORS: INDICATIONS, TECHNIQUES AND OUTCOMESJournal of Urology, 2001
- Incidental renal cell carcinoma—age and stage characterization and clinical implications: study of 1092 patients (1982–1997)Urology, 2000
- Intrarenal satellites of renal cell carcinoma: Histopathologic manifestation and clinical implicationUrology, 1995
- Prognostic significance of morphologic parameters in renal cell carcinomaThe American Journal of Surgical Pathology, 1982