Clinical efficacy of radical nephrectomy versus nephron-sparing surgery on localized renal cell carcinoma

Li, Wentao; Cheng, Yue; Yi, Cheng; Ren, Hui; Han, Na

doi:10.1186/s40001-014-0058-4

Cited by 10 publications

(8 citation statements)

References 33 publications

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“…[7] In the literature, many studies have investigated the incidence of renal malignancies in various age groups. [1][2][3][4][5][6] In a large series Open partial nephrectomy, n (%) 4 (14) 21 (21) Laparoscopic radical nephrectomy, n (%) 2 (7) 11 (11) Fuhrman grading system (for only malignancies), n (%) consisting of 2710 cases, RCC was reported in 2164 cases; 4% of which comprised of patients aged between 20 and 40 years.…”

Section: Discussionmentioning

confidence: 99%

The relationship between histopathology and age factor in patients who were operated for renal masses

Yıkılmaz

Baş

Arık

et al. 2015

Turkish Journal of Urology

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Objective: Renal neoplasms have a predilection to occur in older patients and they are often malignant. They may have different structural characteristics according to age groups. In our study, we have investigated age-related demographic characteristics of the patients who were operated because of suspected malignant renal masses. Material and methods:Between 2010 and 2014, 129 patients were treated surgically for suspected malignant renal masses at our institution. These cases had undergone open radical, open partial, and laparoscopic radical nephrectomies. Patients were divided into two groups based on their ages and evaluated accordingly as Group 1 (≤50 years) and Group 2 (>50 years). Groups were compared based on their clinical and pathological features.Results: Group 1 and Group 2 consisted of 29 (22.4%) and 91 (77.6%) patients, respectively. The mean age of younger patients was 43.1 years (23-49 years), with a male to female ratio of 19/10, while the average tumor size was 57.6 mm (20-120 mm). Twenty-four patients (83%) had a malignant pathology and five patients (17%) had a benign pathology. Clear cell carcinoma was diagnosed in 67% of the patients in both groups. There was no significant difference with respect to age and tumor size of male and female patients in the younger age group, while younger female adults tended to have a more benign pathology than their male counterparts (40% and 5%, respectively, p<0.05). Conclusion:There was no significant difference with respect to gender, tumor size, laterality, and surgical and pathologic features between younger and older patients. An organ-sparing approach should be strongly considered when treatment for renal tumors in young females is performed because of a potentially higher incidence of a benign pathology of renal masses.

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Section: Discussionmentioning

confidence: 99%

The relationship between histopathology and age factor in patients who were operated for renal masses

Yıkılmaz

Baş

Arık

et al. 2015

Turkish Journal of Urology

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“…Currently, a large number of meta analyses regarding the comparison of radical nephrectomy (RN) and PN have been reported (7, 8), but few are about the comparison of TE and PN. Minervini et al (9) performed a meta-analysis comparing several oncologic outcomes following TE and PN for renal cell carcinoma, and demonstrated that TE was at least non-inferior to PN.…”

Section: Introductionmentioning

confidence: 99%

Tumor Enucleation vs. Partial Nephrectomy for T1 Renal Cell Carcinoma: A Systematic Review and Meta-Analysis

Lin

et al. 2019

Front. Oncol.

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Purpose: Tumor enucleation (TE) and partial nephrectomy (PN) have both become main treatment strategies for T1 renal cell carcinoma (RCC), despite the discrepancy between their safety margin. We performed a meta-analysis on all the relevant trials in order to compare the clinical efficacy and safety of TE with those of PN for RCC treatment. Methods: In this meta-analysis, randomized controlled trials or retrospective studies were included if they compared TE and PN therapy in patients with localized renal cancer. The main outcomes extracted were perioperative data and post-operative outcomes. Subgroups for analyses were undertaken according to tumor size and duration of follow up. Data were pooled using the generic variance method with a fixed or random effects model and expressed as mean differences or odds ratios with 95% CI. Results: A total of 13 studies containing 1,792 patients undergoing TE and 3,068 undergoing PN were identified. Our study showed that the patients received TE had significantly shorter operative time (MD = −28.46, 95% CI = −42.09, −14.83, P < 0.0001), less hospital day (MD = −0.68, 95% CI = −1.04, −0.31, P = 0.0003), less estimate blood loss (MD = −59.90, 95% CI = −93.23, −26.58, P = 0.0004) and smaller change in estimated glomerular filtration rate (fixed effect: MD = 4.66, 95% CI = 1.67, 7.66, P = 0.002), fewer complications (fixed effect: OR = 0.65, 95% CI = 0.50, 0.85, P = 0.001) compared with those received PN. However, there were no significant differences in terms of warm ischemic time, positive margin rates, recurrence rates and survival rates between the two groups. All the subgroup analyses presented consistent results with the overall analyses. Conclusions: Our findings suggested that TE is not only less-traumatizing and beneficial for recovery, but also better for renal function protection. Moreover, it did not show the evidence of an increase relapse rate or mortality rate when compared with PN.

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“…Although local recurrence rate is potentially higher in the partial nephrectomy group ( Fig. 16.4a, b ), a recent meta-analysis has shown that NSS had a signifi cantly lower cancer-specifi c death rate compared with RN, but there was no signifi cant difference in the rate of tumour recurrence and complications between the two techniques [ 20 ].…”

Section: Open Partial Nephrectomy (Pn) or Nephron-sparing Surgery (Nss)mentioning

confidence: 96%

Treatment of Renal Cell Carcinomas

Kurukkal

Al-Busaidy

2015

Urological Cancer Management

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Small renal masses (SRMs) are defi ned as lesions ≤4 cm in dimension, i.e. T1a . They are an increasingly common clinical scenario for practising urologists and physicians, and contemporary epidemiological studies indicate that SRMs account for nearly one half of all diagnosed renal masses diagnosed . SRMs are biologically heterogeneous with 20 % being benign lesions, while 20-30 % others are potentially aggressive at the time of diagnosis [ 1 ] ( Fig. 16.1 ).SRMs are slow growing, and the average growth rate of RCC is 0.28 cm/year . They seldom progress to metastasize, which was reported in only 1 % of patients [ 3 ]. However, the growth rate of a renal mass does not predict malignancy with certainty as even tumours with zero growth rate have a malignant potential [ 4 ]. Neither clinical nor radiographic features can reliably categorize SRMs as benign or malignant and differentiate between indolent and potentially aggressive tumours.So far, there is no established protocol for active surveillance of renal tumours. The tumour size may be an indicator of biological aggressiveness. In clinical T1b lesions (4-7 cm), the rate of tumour growth is 1.43 cm/year , and one out of nine patients develops metastasis. The risk of synchronous metastases increases to 22 % with each 1 cm rise in tumour size [ 5 ].Renal mass biopsy with molecular analysis can assess the aggressive potential and guide in decision-making between active surveillance and active treatment.

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Clinical efficacy of radical nephrectomy versus nephron-sparing surgery on localized renal cell carcinoma

Cited by 10 publications

References 33 publications

The relationship between histopathology and age factor in patients who were operated for renal masses

The relationship between histopathology and age factor in patients who were operated for renal masses

Tumor Enucleation vs. Partial Nephrectomy for T1 Renal Cell Carcinoma: A Systematic Review and Meta-Analysis

Treatment of Renal Cell Carcinomas

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