Partial versus radical nephrectomy for clinically organ confined clear cell RCC
Introduction: Partial Nephrectomy (PN) has become a standard of treatment for cT1 renal tumors. However, few studies compared the oncologic outcomes of PN and radical nephrectomy (RN) for pT2-3a clear cell renal cell carcinoma (cc-RCC). In this study we compared cancer specific survival of PN and RN performed in patients with cT1-2-cN0-cM0 renal tumors and pT1a-pT3a-pNx cc-RCC.
Material & Methods: Data were prospectively collected into the “Regina Elena” National Cancer Institute “renal surgery” database from 2001 to 2013. Out of 1650 cases, 921 were cc-RCC and 654 patients met inclusion criteria (cT<3-cN0-cM0 and pT1a-pT3a-pNx), 252 of which treated with RN and 402 with PN. Univariable analysis was performed to compare cancer specific survival between PN and RN groups.
Results: Patients treated with RN had larger tumors (p < 0.001), higher pT stages (p < 0.001) and higher incidences of Fuhrman G3-4 (p = 0.004). (Table 1)
At log rank test CSS was not different between PN and RN group (p = 0.926; Figure 1).
After stratifying for pT stage and Fuhrman grade no difference was found in terms of CSS at univariable analyses. (Figure 2)
Conclusions: In our series PN and RN demonstrated equivalent cancer control in the treatment cT<3-N0-M0 cc-RCC