Abstract:
INTRODUCTION:With low life expectancy rates in hemodialysis patients, the preservation of renal parenchyma must be weighed against the oncological outcomes in considering partial nephrectomy (PN) in solitary kidneys. The main objective of this study was to assess the oncologic and functional outcomes after PN in patients with solitary kidneys. METHODS:A retrospective analysis of the Columbia University Medical Center Urologic Oncology database found 38 patients who underwent PN in the setting of a solitary kidney from 1988-2008. Chronic kidney disease (CKD) was defined as GFR of <60 cc/min/1.73 m(2). Kaplan-Meier analysis was used to estimate overall survival, cancer-specific survival, and local recurrence-free survival. RESULTS:The study group was followed for a median of 29 months, with a mean age of 63.2 years (range 35-83). Only one patient required postoperative long-term hemodialysis. Two out of 38 patients had a Clavien III postoperative complication. Twenty-one (55.3%) of the patients had preoperative CKD, while 29 (76%) patients had CKD postoperatively. Those who had CKD at the most recent follow-up had significantly larger tumors removed (P < 0.05). Of the 32 patients with renal cell carcinoma (RCC), 6 (18.8%) had a local recurrence at a median 32.6 months. The 5-year overall, disease-specific, and recurrence-free survival rates were 59.6, 77.5, and 45.7%, respectively. CONCLUSION:PN in the setting of a solitary kidney poses difficult challenges for surgical and clinical management. Nephron sparing surgery for the treatment of RCC is feasible with low surgical complication rates, satisfactory disease-specific survival rates, and acceptable preservation of renal function.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Lee DJ,Hruby G,Benson MC,McKiernan JMdoi
10.1007/s00345-010-0576-9subject
Has Abstractpub_date
2011-06-01 00:00:00pages
343-8issue
3eissn
0724-4983issn
1433-8726journal_volume
29pub_type
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journal_title:World journal of urology
pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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pub_type: 杂志文章,已发布勘误
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更新日期:2020-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 临床试验,杂志文章
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更新日期:2016-10-01 00:00:00
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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journal_title:World journal of urology
pub_type: 杂志文章
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journal_title:World journal of urology
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:1996-01-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2012-08-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:2005-06-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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journal_title:World journal of urology
pub_type: 杂志文章,评审
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更新日期:1998-01-01 00:00:00
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journal_title:World journal of urology
pub_type: 杂志文章
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更新日期:2014-12-01 00:00:00
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pub_type: 杂志文章,评审
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