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Nephron-sparing surgery versus radical nephrectomy in the treatment of intracapsular renal cell carcinoma up to 7cm.

Abstract：

OBJECTIVE:To compare the oncologic outcomes of nephron-sparing surgery versus radical nephrectomy in intracapsular renal cell carcinoma (RCC) up to 7 cm by reviewing surgical experience retrospectively. METHODS:Data from 1290 consecutive patients who had surgery for RCC have been stored in a dedicated database since 1983. We selected and reviewed those related to disease-free patients who had been treated for unilateral pT1a/pT1b pN0/Nx M0 carcinomas up to 7 cm and later followed for a minimum of 12 mo. RESULTS:A total of 642 patients with mean follow-up of 72.9 mo were selected; 313 had been treated for tumours <4 cm in diameter (176 nephron-sparing surgery, 137 nephrectomy), whereas 329 had been treated for tumours measuring > or =4 cm (52 nephron-sparing surgery, 277 nephrectomy). The comparison between tumours <4 cm or > or =4 cm in diameter showed worse progression and disease-free survival rates for the latter, but the type of surgery (nephron-sparing or radical) seemed to have no significant impact. CONCLUSIONS:Conservative management can be cautiously suggested for RCC up to 7 cm because the worsening of prognosis as diameter increases shows no statistical differences for either nephron-sparing or radical surgery. The agreement of our results with those of similar studies available in the literature may suggest designing a prospective study to compare conservative and more radical surgery in the management of RCC up to 7 cm.

journal_name

Eur Urol

journal_title

European urology

authors

Antonelli A,Cozzoli A,Nicolai M,Zani D,Zanotelli T,Perucchini L,Cunico SC,Simeone C

doi

10.1016/j.eururo.2007.11.007

subject

Has Abstract

pub_date

2008-04-01 00:00:00

pages

803-9

issue

4

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(07)01424-8

journal_volume

53

pub_type

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