Nephron-sparing surgery for localized renal cell carcinoma with a normal contralateral kidney: a European three-center experience (Journal article)

Delakas, D./ Karyotis, I./ Daskalopoulos, G./ Terhorst, B./ Lymberopoulos, S./ Cranidis, A.

OBJECTIVES: To assess the long-term effectiveness and safety of nephron-sparing surgery for the treatment of localized renal cell carcinoma with a normal contralateral kidney. METHODS: Since 1973, 118 patients have undergone nephron-sparing surgery for renal cell carcinoma on an elective basis at our institutions. The vast majority of these tumors were incidental findings, with a mean tumor diameter of 3.35 cm (range 0.7 to 5.6). The median follow-up was 8.5 years (range 0.5 to 18), and of those patients alive, 27 (28%) were followed up for more than 10 years. RESULTS: The pathologic stage was pT1N0M0 in 110 cases (93.2%) and pT3aN0M0 in 8 (6.7%); 59 were grade 1, 52 were grade 2, and 7 were grade 3. Complications occurred in 4 patients, including retroperitoneal bleeding in 1 treated by reoperation, urinomas in 2, and ureteral stricture in 1 treated conservatively. Renal function remained normal during the whole follow-up period, and slight proteinuria was observed in 13 patients. The 10-year distant and local recurrence rate was 4% and 3.9%, respectively. The cancer-specific 5, 10, and 15-year survival rate was 97.3%, 96.4%, and 96.4%, respectively. CONCLUSIONS: Our experience, based on a long median follow-up, suggests that nephron-sparing surgery on an elective basis can achieve long-term survival for the treatment of incidental and low-stage renal cell carcinomas without compromising the efficacy of cancer treatment.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Keywords: Adult,Aged,Carcinoma, Renal Cell/mortality/*pathology/*surgery,Female,Follow-Up Studies,Humans,Incidental Findings,Kidney Neoplasms/mortality/*pathology/*surgery,Lymph Node Excision,Male,Middle Aged,Neoplasm Recurrence, Local/pathology,Neoplasm Staging,Nephrectomy/*methods/mortality,Nephrons,Retrospective Studies,Surgical Procedures, Elective,Survival Rate
ISSN: 1527-9995
Appears in Collections:Άρθρα σε επιστημονικά περιοδικά ( Ανοικτά)

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