Oncologic and functional outcomes after partial nephrectomy versus radical nephrectomy in T1b renal cell carcinoma: A multicenter, matched case-control study in Korean patients

Hoon Ah Jang, Jin Wook Kim, Seok Soo Byun, Sung Hoo Hong, Young Jun Kim, Young Hyun Park, Kyung Suk Yang, Seok Cho, Jun Cheon, Seok Ho Kang

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

Purpose The study was to compare the oncologic and functional outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for pathologically proven T1b renal cell carcinoma using pair-matched groups. Materials and Methods We reviewed our prospectively maintained database for RN and PN in T1b renal tumors surgically treated between 1999 and 2011 at five institutions in Korea. Of 611 patients treated with PN or RN for a solitary and NX/N0 M0 renal mass (4-7 cm), 577 (PN, 100; RN, 477) patients with pathologically confirmed pT1b remained for analysis. Study subjects were grouped by PN or RN, then matched by age, sex, comorbidities, body mass index, tumor size and depth, histologic type, and preoperative estimated glomerular filtration rate (eGFR) using propensities score. To evaluate oncologic outcomes, overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were analyzed. The functional outcomes were evaluated by postoperative eGFR. Results The median follow-up in the RN group was 48.1 and 42.6 months in the PN group. The estimated 10-year CSS rate (PN 85.7% vs. RN 84.4%, p=0.52) and 5-and estimated 10-year PFS rates (PN: 86.4% and 79.2% vs. RN: 86.0% and 66.1%, p=0.66) did not differ significantly between groups. The estimated 10-year OS rate was significantly higher in the PN group (85.7%) compared to the RN group (73.3%) (p=0.003). PN was less likely to induce new-onset chronic kidney disease (CKD) and end-stage CKD compared with RN. Conclusion Our study suggests that patients treated with PN demonstrate a superior OS rate and postoperative renal function with analogous CSS and PFS rates compared with pair-matched patients treated with RN.

Original languageEnglish
Pages (from-to)612-620
Number of pages9
JournalCancer Research and Treatment
Volume48
Issue number2
DOIs
Publication statusPublished - 2016 Apr 1

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Nephrectomy
Renal Cell Carcinoma
Case-Control Studies
Survival Rate
Disease-Free Survival
Neoplasms
Glomerular Filtration Rate
Chronic Renal Insufficiency
Kidney
Survival
Propensity Score

Keywords

  • Nephron-sparing surgery
  • Partial nephrectomy
  • Renal cell carcinoma
  • T1b

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Oncologic and functional outcomes after partial nephrectomy versus radical nephrectomy in T1b renal cell carcinoma : A multicenter, matched case-control study in Korean patients. / Jang, Hoon Ah; Kim, Jin Wook; Byun, Seok Soo; Hong, Sung Hoo; Kim, Young Jun; Park, Young Hyun; Yang, Kyung Suk; Cho, Seok; Cheon, Jun; Kang, Seok Ho.

In: Cancer Research and Treatment, Vol. 48, No. 2, 01.04.2016, p. 612-620.

Research output: Contribution to journalArticle

Jang, Hoon Ah ; Kim, Jin Wook ; Byun, Seok Soo ; Hong, Sung Hoo ; Kim, Young Jun ; Park, Young Hyun ; Yang, Kyung Suk ; Cho, Seok ; Cheon, Jun ; Kang, Seok Ho. / Oncologic and functional outcomes after partial nephrectomy versus radical nephrectomy in T1b renal cell carcinoma : A multicenter, matched case-control study in Korean patients. In: Cancer Research and Treatment. 2016 ; Vol. 48, No. 2. pp. 612-620.
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abstract = "Purpose The study was to compare the oncologic and functional outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for pathologically proven T1b renal cell carcinoma using pair-matched groups. Materials and Methods We reviewed our prospectively maintained database for RN and PN in T1b renal tumors surgically treated between 1999 and 2011 at five institutions in Korea. Of 611 patients treated with PN or RN for a solitary and NX/N0 M0 renal mass (4-7 cm), 577 (PN, 100; RN, 477) patients with pathologically confirmed pT1b remained for analysis. Study subjects were grouped by PN or RN, then matched by age, sex, comorbidities, body mass index, tumor size and depth, histologic type, and preoperative estimated glomerular filtration rate (eGFR) using propensities score. To evaluate oncologic outcomes, overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were analyzed. The functional outcomes were evaluated by postoperative eGFR. Results The median follow-up in the RN group was 48.1 and 42.6 months in the PN group. The estimated 10-year CSS rate (PN 85.7{\%} vs. RN 84.4{\%}, p=0.52) and 5-and estimated 10-year PFS rates (PN: 86.4{\%} and 79.2{\%} vs. RN: 86.0{\%} and 66.1{\%}, p=0.66) did not differ significantly between groups. The estimated 10-year OS rate was significantly higher in the PN group (85.7{\%}) compared to the RN group (73.3{\%}) (p=0.003). PN was less likely to induce new-onset chronic kidney disease (CKD) and end-stage CKD compared with RN. Conclusion Our study suggests that patients treated with PN demonstrate a superior OS rate and postoperative renal function with analogous CSS and PFS rates compared with pair-matched patients treated with RN.",
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T1 - Oncologic and functional outcomes after partial nephrectomy versus radical nephrectomy in T1b renal cell carcinoma

T2 - A multicenter, matched case-control study in Korean patients

AU - Jang, Hoon Ah

AU - Kim, Jin Wook

AU - Byun, Seok Soo

AU - Hong, Sung Hoo

AU - Kim, Young Jun

AU - Park, Young Hyun

AU - Yang, Kyung Suk

AU - Cho, Seok

AU - Cheon, Jun

AU - Kang, Seok Ho

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N2 - Purpose The study was to compare the oncologic and functional outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for pathologically proven T1b renal cell carcinoma using pair-matched groups. Materials and Methods We reviewed our prospectively maintained database for RN and PN in T1b renal tumors surgically treated between 1999 and 2011 at five institutions in Korea. Of 611 patients treated with PN or RN for a solitary and NX/N0 M0 renal mass (4-7 cm), 577 (PN, 100; RN, 477) patients with pathologically confirmed pT1b remained for analysis. Study subjects were grouped by PN or RN, then matched by age, sex, comorbidities, body mass index, tumor size and depth, histologic type, and preoperative estimated glomerular filtration rate (eGFR) using propensities score. To evaluate oncologic outcomes, overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were analyzed. The functional outcomes were evaluated by postoperative eGFR. Results The median follow-up in the RN group was 48.1 and 42.6 months in the PN group. The estimated 10-year CSS rate (PN 85.7% vs. RN 84.4%, p=0.52) and 5-and estimated 10-year PFS rates (PN: 86.4% and 79.2% vs. RN: 86.0% and 66.1%, p=0.66) did not differ significantly between groups. The estimated 10-year OS rate was significantly higher in the PN group (85.7%) compared to the RN group (73.3%) (p=0.003). PN was less likely to induce new-onset chronic kidney disease (CKD) and end-stage CKD compared with RN. Conclusion Our study suggests that patients treated with PN demonstrate a superior OS rate and postoperative renal function with analogous CSS and PFS rates compared with pair-matched patients treated with RN.

AB - Purpose The study was to compare the oncologic and functional outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for pathologically proven T1b renal cell carcinoma using pair-matched groups. Materials and Methods We reviewed our prospectively maintained database for RN and PN in T1b renal tumors surgically treated between 1999 and 2011 at five institutions in Korea. Of 611 patients treated with PN or RN for a solitary and NX/N0 M0 renal mass (4-7 cm), 577 (PN, 100; RN, 477) patients with pathologically confirmed pT1b remained for analysis. Study subjects were grouped by PN or RN, then matched by age, sex, comorbidities, body mass index, tumor size and depth, histologic type, and preoperative estimated glomerular filtration rate (eGFR) using propensities score. To evaluate oncologic outcomes, overall survival (OS), cancer-specific survival (CSS), and progression-free survival (PFS) rates were analyzed. The functional outcomes were evaluated by postoperative eGFR. Results The median follow-up in the RN group was 48.1 and 42.6 months in the PN group. The estimated 10-year CSS rate (PN 85.7% vs. RN 84.4%, p=0.52) and 5-and estimated 10-year PFS rates (PN: 86.4% and 79.2% vs. RN: 86.0% and 66.1%, p=0.66) did not differ significantly between groups. The estimated 10-year OS rate was significantly higher in the PN group (85.7%) compared to the RN group (73.3%) (p=0.003). PN was less likely to induce new-onset chronic kidney disease (CKD) and end-stage CKD compared with RN. Conclusion Our study suggests that patients treated with PN demonstrate a superior OS rate and postoperative renal function with analogous CSS and PFS rates compared with pair-matched patients treated with RN.

KW - Nephron-sparing surgery

KW - Partial nephrectomy

KW - Renal cell carcinoma

KW - T1b

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