Radical versus partial nephrectomy
Open Access
- 4 February 2009
- Vol. 115 (7), 1465-1471
- https://doi.org/10.1002/cncr.24035
Abstract
BACKGROUND: Relative to radical nephrectomy (RN), partial nephrectomy (PN) performed for renal cell carcinoma (RCC) may protect from non‐cancer‐related deaths. The authors tested this hypothesis in a cohort of PN and RN patients. METHODS: The Surveillance, Epidemiology, and End Results‐9 database allowed identification of 2198 PN (22.4%) and 7611 RN (77.6%) patients treated for T1aN0M0 RCC between 1988 and 2004. Analyses matched for age, year of surgery, tumor size, and Fuhrman grade addressed the effect of nephrectomy type (RN vs PN) on overall mortality (Cox regression models) and on non‐cancer‐related mortality (competing‐risks regression models). RESULTS: Relative to PN, RN was associated with 1.23‐fold (P = .001) increased overall mortality rate, which translated into a 4.9% and 3.1% absolute increase in mortality at 5 and 10 years after surgery, respectively. Similarly, non‐cancer‐related death rate was significantly higher after RN in competing‐risks regression models (P < .001), which translated into a 4.6% and 4.5% absolute increase in non‐cancer‐related mortality at 5 and 10 years after surgery, respectively. CONCLUSIONS: Relative to PN, RN predisposes to an increase in overall mortality and non‐cancer‐related death rate in patients with T1a RCC. In consequence, PN should be attempted whenever technically feasible. Selective referrals should be considered if PN expertise is unavailable Cancer 2009. © 2009 American Cancer Society.Keywords
This publication has 17 references indexed in Scilit:
- Nephron-Sparing Surgery versus Radical Nephrectomy in the Treatment of Intracapsular Renal Cell Carcinoma up to 7cmEuropean Urology, 2008
- Analysis of clinicopathologic predictors of oncologic outcome provides insight into the natural history of surgically managed papillary renal cell carcinomaCancer, 2008
- Diffusion of surgical innovation among patients with kidney cancerCancer, 2008
- Radical Nephrectomy for pT1a Renal Masses May be Associated With Decreased Overall Survival Compared With Partial NephrectomyJournal of Urology, 2008
- A Review on Follow-Up Strategies for Renal Cell Carcinoma after NephrectomyEuropean Urology, 2007
- Open Radical Nephrectomy versus Open Partial Nephrectomy: Is It Still an Issue?European Urology, 2007
- Minimally Invasive Nephron-Sparing Surgery (MINSS) for Renal Tumours: Part I: Laparoscopic Partial NephrectomyEuropean Urology, 2007
- Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort studyThe Lancet Oncology, 2006
- Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and HospitalizationNew England Journal of Medicine, 2004
- Validation of a combined comorbidity indexJournal of Clinical Epidemiology, 1994