Partial nephrectomy versus radical nephrectomy for non-metastatic pathological T3a renal cell carcinoma

A multi-institutional comparative analysis

Jong Jin Oh, Seok Soo Byun, Sang Eun Lee, Sung Kyu Hong, Eun Sik Lee, Hyeon Hoe Kim, Cheol Kwak, Ja Hyeon Ku, Chang Wook Jeong, Yong June Kim, Seok Ho Kang, Sung Hoo Hong

Research output: Contribution to journalArticle

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Abstract

Objectives: To compare the recurrence-free survival of partial nephrectomy and radical nephrectomy in patients with non-metastatic pathological T3a renal cell carcinoma. Methods: We reviewed the records of 3567 patients who had undergone a nephrectomy for renal cell carcinoma at five institutions in Korea from January 2000 to December 2010. The clinical data of 45 patients with pathological T3a renal cell carcinoma in the partial nephrectomy group were compared with 298 patients with pathological T3a renal cell carcinoma in the radical nephrectomy group. The effects of surgical methods on recurrence-free survival were assessed by a multivariate Cox proportional hazard analysis. All comparisons were repeated in subgroup analysis on 63 clinical T1a patients with tumors ≤4cm. Results: During a median 43-month follow-up period, disease recurrence occurred in two patients (4.4%) in the partial nephrectomy group, and 94 patients (31.5%) in the radical nephrectomy group. The results from a multivariate model showed that radical nephrectomy was a significant predictor of recurrence. However, in subgroup analysis that included 63 clinical T1a pathological T3a patients, the recurrence-free survival rates were not significantly different between the two cohorts. The renal function was significantly better preserved in the partial nephrectomy cohort than in the radical nephrectomy cohort. Conclusions: Partial nephrectomy provides similar recurrence-free survival outcomes compared with radical nephrectomy in patients with clinical T1a pathological T3a renal cell carcinoma. However, there seems to be a higher risk of recurrence for large pathological T3a tumors treated by radical nephrectomy compared with small tumors treated by partial nephrectomy. Thus, large tumors with the same pathological T3a renal cell carcinoma grade could have hidden aggressive features.

Original languageEnglish
Pages (from-to)352-357
Number of pages6
JournalInternational Journal of Urology
Volume21
Issue number4
DOIs
Publication statusPublished - 2014 Jan 1

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Nephrectomy
Renal Cell Carcinoma
Recurrence
Survival
Neoplasms
Korea
Survival Rate

Keywords

  • Kidney
  • Nephrectomy
  • Partial nephrectomy
  • Radical nephrectomy
  • Renal cell carcinoma

ASJC Scopus subject areas

  • Urology

Cite this

Partial nephrectomy versus radical nephrectomy for non-metastatic pathological T3a renal cell carcinoma : A multi-institutional comparative analysis. / Oh, Jong Jin; Byun, Seok Soo; Lee, Sang Eun; Hong, Sung Kyu; Lee, Eun Sik; Kim, Hyeon Hoe; Kwak, Cheol; Ku, Ja Hyeon; Jeong, Chang Wook; Kim, Yong June; Kang, Seok Ho; Hong, Sung Hoo.

In: International Journal of Urology, Vol. 21, No. 4, 01.01.2014, p. 352-357.

Research output: Contribution to journalArticle

Oh, Jong Jin ; Byun, Seok Soo ; Lee, Sang Eun ; Hong, Sung Kyu ; Lee, Eun Sik ; Kim, Hyeon Hoe ; Kwak, Cheol ; Ku, Ja Hyeon ; Jeong, Chang Wook ; Kim, Yong June ; Kang, Seok Ho ; Hong, Sung Hoo. / Partial nephrectomy versus radical nephrectomy for non-metastatic pathological T3a renal cell carcinoma : A multi-institutional comparative analysis. In: International Journal of Urology. 2014 ; Vol. 21, No. 4. pp. 352-357.
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abstract = "Objectives: To compare the recurrence-free survival of partial nephrectomy and radical nephrectomy in patients with non-metastatic pathological T3a renal cell carcinoma. Methods: We reviewed the records of 3567 patients who had undergone a nephrectomy for renal cell carcinoma at five institutions in Korea from January 2000 to December 2010. The clinical data of 45 patients with pathological T3a renal cell carcinoma in the partial nephrectomy group were compared with 298 patients with pathological T3a renal cell carcinoma in the radical nephrectomy group. The effects of surgical methods on recurrence-free survival were assessed by a multivariate Cox proportional hazard analysis. All comparisons were repeated in subgroup analysis on 63 clinical T1a patients with tumors ≤4cm. Results: During a median 43-month follow-up period, disease recurrence occurred in two patients (4.4{\%}) in the partial nephrectomy group, and 94 patients (31.5{\%}) in the radical nephrectomy group. The results from a multivariate model showed that radical nephrectomy was a significant predictor of recurrence. However, in subgroup analysis that included 63 clinical T1a pathological T3a patients, the recurrence-free survival rates were not significantly different between the two cohorts. The renal function was significantly better preserved in the partial nephrectomy cohort than in the radical nephrectomy cohort. Conclusions: Partial nephrectomy provides similar recurrence-free survival outcomes compared with radical nephrectomy in patients with clinical T1a pathological T3a renal cell carcinoma. However, there seems to be a higher risk of recurrence for large pathological T3a tumors treated by radical nephrectomy compared with small tumors treated by partial nephrectomy. Thus, large tumors with the same pathological T3a renal cell carcinoma grade could have hidden aggressive features.",
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AU - Hong, Sung Kyu

AU - Lee, Eun Sik

AU - Kim, Hyeon Hoe

AU - Kwak, Cheol

AU - Ku, Ja Hyeon

AU - Jeong, Chang Wook

AU - Kim, Yong June

AU - Kang, Seok Ho

AU - Hong, Sung Hoo

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N2 - Objectives: To compare the recurrence-free survival of partial nephrectomy and radical nephrectomy in patients with non-metastatic pathological T3a renal cell carcinoma. Methods: We reviewed the records of 3567 patients who had undergone a nephrectomy for renal cell carcinoma at five institutions in Korea from January 2000 to December 2010. The clinical data of 45 patients with pathological T3a renal cell carcinoma in the partial nephrectomy group were compared with 298 patients with pathological T3a renal cell carcinoma in the radical nephrectomy group. The effects of surgical methods on recurrence-free survival were assessed by a multivariate Cox proportional hazard analysis. All comparisons were repeated in subgroup analysis on 63 clinical T1a patients with tumors ≤4cm. Results: During a median 43-month follow-up period, disease recurrence occurred in two patients (4.4%) in the partial nephrectomy group, and 94 patients (31.5%) in the radical nephrectomy group. The results from a multivariate model showed that radical nephrectomy was a significant predictor of recurrence. However, in subgroup analysis that included 63 clinical T1a pathological T3a patients, the recurrence-free survival rates were not significantly different between the two cohorts. The renal function was significantly better preserved in the partial nephrectomy cohort than in the radical nephrectomy cohort. Conclusions: Partial nephrectomy provides similar recurrence-free survival outcomes compared with radical nephrectomy in patients with clinical T1a pathological T3a renal cell carcinoma. However, there seems to be a higher risk of recurrence for large pathological T3a tumors treated by radical nephrectomy compared with small tumors treated by partial nephrectomy. Thus, large tumors with the same pathological T3a renal cell carcinoma grade could have hidden aggressive features.

AB - Objectives: To compare the recurrence-free survival of partial nephrectomy and radical nephrectomy in patients with non-metastatic pathological T3a renal cell carcinoma. Methods: We reviewed the records of 3567 patients who had undergone a nephrectomy for renal cell carcinoma at five institutions in Korea from January 2000 to December 2010. The clinical data of 45 patients with pathological T3a renal cell carcinoma in the partial nephrectomy group were compared with 298 patients with pathological T3a renal cell carcinoma in the radical nephrectomy group. The effects of surgical methods on recurrence-free survival were assessed by a multivariate Cox proportional hazard analysis. All comparisons were repeated in subgroup analysis on 63 clinical T1a patients with tumors ≤4cm. Results: During a median 43-month follow-up period, disease recurrence occurred in two patients (4.4%) in the partial nephrectomy group, and 94 patients (31.5%) in the radical nephrectomy group. The results from a multivariate model showed that radical nephrectomy was a significant predictor of recurrence. However, in subgroup analysis that included 63 clinical T1a pathological T3a patients, the recurrence-free survival rates were not significantly different between the two cohorts. The renal function was significantly better preserved in the partial nephrectomy cohort than in the radical nephrectomy cohort. Conclusions: Partial nephrectomy provides similar recurrence-free survival outcomes compared with radical nephrectomy in patients with clinical T1a pathological T3a renal cell carcinoma. However, there seems to be a higher risk of recurrence for large pathological T3a tumors treated by radical nephrectomy compared with small tumors treated by partial nephrectomy. Thus, large tumors with the same pathological T3a renal cell carcinoma grade could have hidden aggressive features.

KW - Kidney

KW - Nephrectomy

KW - Partial nephrectomy

KW - Radical nephrectomy

KW - Renal cell carcinoma

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