Nephron-sparing Techniques Independently Decrease the Risk of Cardiovascular Events Relative to Radical Nephrectomy in Patients with a T1a–T1b Renal Mass and Normal Preoperative Renal Function

Abstract

Background: Some reports have suggested that nephron-sparing surgery (NSS) may protect against cardiovascular events (CVe) when compared with radical nephrectomy (RN). However, previous studies did not adjust the results for potential selection bias secondary to baseline cardiovascular risk. Objective: To test the effect of treatment type (NSS vs RN) on the risk of developing CVe after accounting for individual cardiovascular risk. Design, setting, and participants: A multi-institutional collaboration including 1331 patients with a clinical T1a-T1b N0 M0 renal mass and normal renal function before surgery (defined as an estimated glomerular filtration rate 60 ml/min/1.73 m

Predictive factors of overall and major postoperative complications after partial nephrectomy: Results from a multicenter prospective study (The RECORd 1 project)

“…13 Conversely, the European Organization for Research and Treatment of Cancer (EORTC) trial 30904 demonstrates that PN seems to be significantly less effective than RN in terms of overall survival and several studies reported a significantly higher postoperative complication rates of PN in complex renal masses and/or comorbid patients. 14 To date, the controversial opinions about the risk/benefit ratio of both PN and RN along with the clinical features of each patient often influenced the treatment decision for localized RCC.…”

End-Stage Renal Disease After Renal Surgery in Patients with Normal Preoperative Kidney Function: Balancing Surgical Strategy and Individual Disorders at Baseline

“…The outcome of the study was ESRD, defined as the onset of a postoperative estimated glomerular filtration rate (GFR) <15 ml/min per 1.73 m 2 . GFR was calculated by the Chronic Kidney Disease Epidemiology Collaboration formula in younger patients (aged <70 yr) and by the Berlin Initiative Study formula in older patients (aged 70 yr) [3]. We included the following covariates: age, year of surgery, preoperative GFR, tumor size, hypertension (none, uncontrolled, or controlled by medical therapy), diabetes, baseline Charlson comorbidity index (CCI), BMI, and smoking status (no, yes, or former).…”

A snapshot of nephron-sparing surgery in Italy: A prospective, multicenter report on clinical and perioperative outcomes (the RECORd 1 project)

“…12 Considering, above all, the functional benefits and the comparable oncological outcomes over RN offered by NSS, partial nephrectomy has been therefore more widely adopted among urological centres. 13,14 In the present study, we evaluated the clinical, demographic, intraoperative and pathological data of those patients undergoing PN between 2009 and 2012 in 19 Italian Institutions. In this study, although the period considered is relatively short (4 years), asymptomatic patients were significantly higher in the second half of the evaluation period.…”