Disease Outcome in Patients With Low Stage Renal Cell Carcinoma Treated With Nephron Sparing or Radical Surgery

Abstract

No AccessJournal of UrologyClinical Urology: Original Article1 Jun 1996Disease Outcome in Patients With Low Stage Renal Cell Carcinoma Treated With Nephron Sparing or Radical Surgery Seth E. Lerner, Craig A. Hawkins, Michael L. Blute, Andreas Grabner, Peter C. Wollan, Jeffrey T. Eickholt, and Horst Zincke Seth E. LernerSeth E. Lerner , Craig A. HawkinsCraig A. Hawkins , Michael L. BluteMichael L. Blute , Andreas GrabnerAndreas Grabner , Peter C. WollanPeter C. Wollan , Jeffrey T. EickholtJeffrey T. Eickholt , and Horst ZinckeHorst Zincke View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)66032-4AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We investigated the outcome of nephron sparing surgery in patients with low grade and low stage (Robson stage II or less) renal cell carcinoma. Materials and Methods: We retrospectively reviewed the records of 185 patients treated with nephron sparing surgery and 209 matched for patient age and sex, and tumor stage and grade who were treated with radical nephrectomy. Kaplan-Meier survival curves were constructed for progression and survival end points. Multivariate analysis was performed to determine the tumor characteristics independently correlated with progression and cancer death. Results: No significant difference was observed with respect to progression-free, crude or cancer specific survival between the nephron sparing surgery and radical nephrectomy groups. Less than 5 percent of the patients treated with conservative nephron sparing surgery had local recurrence. Tumor size was a strong independent predictor of outcome, whereas Robson stage was not. Patients treated with radical nephrectomy had a significant cancer specific and progression-free survival advantages when controlling for tumor diameter and grade. However, no difference was observed in patients with primary tumor diameters of 4 cm. or less. Conclusions: Robson staging is inaccurate in predicting tumor behavior. Patients with tumors larger than 4 cm. and a normal contralateral kidney may be best served by radical nephrectomy rather than elective nephron sparing surgery. However, nephron sparing surgery may result in an outcome similar to that of radical nephrectomy for low grade, low stage renal cell carcinomas of 4 cm. or smaller. References 1 : The results of radical nephrectomy for renal cell carcinoma. J. Urol.1969; 101: 297. Link, Google Scholar 2 : Indications for conservative surgery in certain renal tumors: a study based on the growth pattern of the clear cell carcinoma. J. Urol.1950; 64: 200. Link, Google Scholar 3 : Nephron sparing surgery for renal cell carcinoma. J. Urol.1993; 149: 1. Link, Google Scholar 4 : Bilateral renal cell carcinoma and renal cell carcinoma in the solitary kidney. J. Urol.1984; 132: 450. 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(2018) EDITORIAL COMMENTJournal of Urology, VOL. 159, NO. 4, (1146-1147), Online publication date: 1-Apr-1998.WOLF J (2018) EVALUATION AND MANAGEMENT OF SOLID AND CYSTIC RENAL MASSESJournal of Urology, VOL. 159, NO. 4, (1120-1133), Online publication date: 1-Apr-1998. Volume 155Issue 6June 1996Page: 1868-1873 Advertisement Copyright & Permissions© 1996 by American Urological Association, Inc.MetricsAuthor Information Seth E. Lerner More articles by this author Craig A. Hawkins More articles by this author Michael L. Blute More articles by this author Andreas Grabner More articles by this author Peter C. Wollan More articles by this author Jeffrey T. Eickholt More articles by this author Horst Zincke More articles by this author Expand All Advertisement PDF downloadLoading ...