Partial Versus Radical Nephrectomy for the Clinical T1a Renal Mass

Gershman, Boris; Leibovich, Bradley C.; Kim, Simon P.

doi:10.1016/j.euf.2019.02.005

Cited by 5 publications

(7 citation statements)

References 33 publications

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“…The main goal of PN is to achieve favorable functional outcomes with oncological safety equivalent to radical nephrectomy when treating small renal tumors [ 1 , 2 , 3 , 4 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

“…Partial nephrectomy (PN) is the standard surgical treatment for small renal masses, as it has exhibited superior renal functional preservation and long-term patient survival relative to radical nephrectomy [ 1 , 2 , 3 , 4 ]. Compared with other methods for PN, robot-assisted PN (RAPN), which has become increasingly prominent in recent years, yields fewer intraoperative and postoperative complications, superior renal functional outcomes, and lower rates of positive margins and conversion to radical nephrectomy than open and laparoscopic PN [ 5 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Benefits of Indocyanine Green Fluorescence in Robot-Assisted Partial Nephrectomy

Yang

Hsieh

Chen

et al. 2022

Cancers

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Background: To compare the intraoperative and postoperative outcomes of indocyanine green (ICG) administration in robot-assisted partial nephrectomy (RAPN) and report the differences in the results between patients with benign and malignant renal tumors. Methods: From 2017 to 2020, 132 patients underwent RAPN at our institution, including 21 patients with ICG administration. Clinical data obtained from our institution’s RAPN database were retrospectively reviewed. Intraoperative, postoperative, pathological, and functional outcomes of RAPN were assessed. Results: The pathological results indicated that among the 127 patients, 38 and 89 had received diagnoses of benign and malignant tumors, respectively. A longer operative time (311 vs. 271 min; p = 0.006) but superior preservation of estimated glomerular filtration rate (eGFR) at 3-month follow-up (90% vs. 85%; p = 0.031) were observed in the ICG-RAPN group. Less estimated blood loss, shorter warm ischemia time, and superior preservation of eGFR at postoperative day 1 and 6-month follow-up were also noted, despite no significant differences. Among the patients with malignant tumors, less estimated blood loss (30 vs. 100 mL; p < 0.001) was reported in the ICG-RAPN subgroup. Conclusions: Patients with ICG-RAPN exhibited superior short-term renal function outcomes compared with the standard RAPN group. Of the patients with malignant tumors, ICG-RAPN was associated with less blood loss than standard RAPN without a more positive margin rate. Further studies with larger cohorts and prospective designs are necessary to verify the intraoperative and functional advantages of the green dye.

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“…The main goal of PN is to achieve favorable functional outcomes with oncological safety equivalent to radical nephrectomy when treating small renal tumors [ 1 , 2 , 3 , 4 , 24 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Benefits of Indocyanine Green Fluorescence in Robot-Assisted Partial Nephrectomy

Yang

Hsieh

Chen

et al. 2022

Cancers

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“…In the previous decade, an offset occurred from radical nephrectomy towards the necessity of nephron-sparing techniques (partial nephrectomy). Preservation surgical techniques have as a goal to preserve renal function and at the same time to have identical oncological results as in radical nephrectomies 14,15 . Also when considering quality of life, renal function and overall survival the majority of studies agree that partial nephrectomy has a significant advantage over radical nephrectomy [16][17][18][19] .…”

Section: Discussionmentioning

confidence: 99%

Comparison of oncologic outcomes between elective partial and radical nephrectomy in patients with renal cell carcinoma in CT1B stadium

et al. 2022

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Background/Aim. In renal cell carcinoma (RCC) the choice of surgical technique, radical (RN) or partial nephrectomy (PN) is still centre dependant because there still are no absolute recommendations for this approach. This study aims to analyze the oncological aspects, time until recurrent disease appears and cancer-specific survival in patients with RCC in T1bN0?0 depending on the type of surgical procedure partial or radical nephrectomy. Methods. A clinical observational study of a series of cases was conducted that analyzed data of 154 patients operated in our institution with a mean follow up a period not less than five years. The inclusion criteria included: renal tumours 4-7 cm, histopathological confirmation of RCC, absence of metastasis and normal serum creatinine. Exclusion criteria included: the presence of other malignancies, solitary functional kidney or comorbidities that can compromise renal function, bilateral tumours or unilateral multiple tumours. Results. The study analyzed data of 154 patients, 97 radical nephrectomies and 57 patients that underwent partial nephrectomy. Analyzing cancer-specific survival in four patients with RN there was a disease advancement that led to a lethal outcome, one PN patient died as a result of local relapse and distant metastasis. Conclusion. Based on our results PN is a good and safe treatment option for patients with RCC in T1b stadium. Partial nephrectomy offers a similar tumour control and better cancer-specific survival.

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Section: What and How To Cutmentioning

confidence: 99%

“…Although nephron-sparing surgery (NSS) offers superior postoperative renal function, partial nephrectomy, especially for anatomically complex masses, may be associated with higher perioperative risks. Gershman et al [7] review the important topic of how to best balance the risk trade-offs of partial versus radical nephrectomy.When partial nephrectomy is performed, technical aspects for resection vary. Groups from the University of Florence and the Mayo Clinic debate the role and safety of enucleation, with Tsivian and colleagues [8] arguing against and Minervini and Carini [9] advocating for the safety and utility of enucleation.Surgeons have long been concerned about permanent damage to the affected renal unit when NSS is performed.…”

mentioning

confidence: 99%

Modern Management of Kidney Cancer: Is a Chance to Cut a Chance to Cure?

Kutikov

2019

European Urology Focus

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Partial Versus Radical Nephrectomy for the Clinical T1a Renal Mass

Cited by 5 publications

References 33 publications

Clinical Benefits of Indocyanine Green Fluorescence in Robot-Assisted Partial Nephrectomy

Clinical Benefits of Indocyanine Green Fluorescence in Robot-Assisted Partial Nephrectomy

Comparison of oncologic outcomes between elective partial and radical nephrectomy in patients with renal cell carcinoma in CT1B stadium

Modern Management of Kidney Cancer: Is a Chance to Cut a Chance to Cure?

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