Partial vs. radical nephrectomy in non-metastatic pT3a kidney cancer patients: a population-based study.

Abstract

BACKGROUND:

The aim of this study was to test for differences in cancer specific mortality (CSM) rates between radical nephrectomy (RN) and partial nephrectomy (PN) in pT3a nmRCC patients.

METHODS:

Within the surveillance, epidemiology, and end results database (2005-2016), 13,177 pT3a patients treated with either PN or RN were identified. Before and after 1:2 ratio propensity score (PS)-match between PN and RN patients, cumulative incidence plot and competing risks regression (CRR) were used to test differences in CSM and other cause mortality (OCM) rates.

RESULTS:

Relative to PN (N.=1615, 22.5%), RN patients harbored higher tumor size (72 vs. 38 mm; >70 mm 51 vs.10%), of more aggressive histology, collecting duct (0.4 vs. 0.2%) and sarcomatoid (2.3 vs.0.8%), of higher grade (51.0 vs. 37.5%). After PS-matching and OCM adjustment, 5-year CSM was 3-fold higher after RN than PN (P<0.01). Similarly, after PS matching and CSM adjustment, also 5-year OCM rates were higher after RN (HR: 1.59, P=0.0003).

CONCLUSIONS:

PN does not appear to compromise the oncological outcomes in patients with pT3a or high-grade renal masses when compared with RN. Therefore, these concerns should not deter a surgeon from attempting PN when otherwise technically feasible.

• Authors: Angela Pecoraro, Daniele Amparore, Matteo Manfredi, Federico Piramide, Enrico Checcucci, Zhe Tian, Dario Peretti, Cristian Fiori, Pierre I Karakiewicz, Francesco Porpiglia
• Journal: Minerva urology and nephrology (Minerva Urol Nephrol) Vol. 74 Issue 4 Pg. 445-451 (Aug 2022) ISSN: 2724-6442 [Electronic] Italy
• PMID: 35147387 (Publication Type: Journal Article)

Topics

• Carcinoma, Renal Cell (pathology, surgery)
• Humans
• Kidney Neoplasms (pathology)
• Nephrectomy (methods)
• Propensity Score
• Treatment Outcome