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Purpose To evaluate the impact of preoperative renal impairment on the oncological outcomes of patients with urothelial carcinoma who underwent radical cystectomy. Materials and Methods We retrospectively reviewed the medical records of patients with urothelial carcinoma who underwent radical cystectomy from 2004 to 2017. All patients who underwent preoperative 99m Tc-diethylenetriaminepentaacetic acid renal scintigraphy (DTPA) were identified. We divided the patients into two groups according to their glomerular filtration rates (GFRs): GFR group 1, GFR≥90 mL/min/1.73 m 2 ; GFR group 2, 60≤GFR<90 mL/min/1.73 m 2 . We included 89 patients in GFR group 1 and 246 patients in GFR group 2 and compared the clinicopathological characteristics and oncological outcomes between the two groups. Results The mean time required for recurrence was 125.5±8.0 months in GFR group 1 and 85.7±7.4 months in GFR group 2 (p=0.030). The mean cancer-specific survival was 131.7±7.8 months in GFR group 1 and 95.5±6.9 months in GFR group 2 (p=0.051). The mean overall survival was 123.3±8.1 months in GFR group 1 and 79.5±6.6 months in GFR group 2 (p=0.004). Conclusions Preoperative GFR values in the range of 60≤GFR<90 mL/min/1.73 m 2 are independent prognostic factors for poor recurrence-free survival, cancer-specific survival, and overall survival in patients after radical cystectomy compared with GFR values of ≥90 mL/min/1.73 m 2 .

Purpose: To compare the oncological outcomes between patients with pathologic T3a (pT3a) renal cell carcinoma (RCC) who underwent partial nephrectomy (PN) and radical nephrectomy (RN).Materials and Methods: We retrospectively reviewed 149 patients with pT3a N0 M0 RCC who underwent PN and RN between 2001 and 2012. Recurrence-free survival (RFS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method and prognostic factors were identified using Cox proportional hazard regression models.Results: A total of 41 recurrences (27.5%) and 24 cancer related death (16.1%) were observed during a median follow-up of 136 months (interquartile range, 77–163 months). We observed no significant differences in the RFS and CSS between the PN and RN (RFS: 85.4±64.0 months vs. 75.9±52.8 months, p=0.061; CSS: 153.2±52.5 months vs. 124.9±59.8 months, p=0.292). The surgical method did not affect the tumor recurrence and patients’ survival. On multivariable Cox regression analysis, only tumor size remained associated with worse RFS (hazard ratio [HR], 1.237; 95% confidence interval [CI], 1.132–1.350; p<0.001) and CSS (HR, 1.156; 95% CI, 1.027–1.302; p=0.017).Conclusions: Due to the large tumor size, there may be hesitation in performing PN concerning pT3a in postoperative biopsy. Our study findings suggest that since tumor size is the only prognostic factor, PN can be performed in pT3a as long as there is no thrombus in the renal vein.