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Comparison of survival and renal function between partial and radical laparoscopic nephrectomy for T1b renal cell carcinoma

  • Feiya Yang
  • Qiang Zhou
  • Nianzeng XingEmail author
Original Article – Clinical Oncology
  • 22 Downloads

Abstract

Purpose

Partial nephrectomy has been persuaded as a widely accepted surgical procedure for T1a (≤ 4 cm) renal tumors. However, when treating T1b (4–7 cm) renal cell carcinoma (RCC), the “optimal” method of surgery is still debatable. The aim of the research is to evaluate the long-term oncological and renal functional outcomes of laparoscopic radical nephrectomy (LRN) versus laparoscopic partial nephrectomy (LPN) for patients with T1b RCC.

Materials and methods

From March 1, 2003 to July 1, 2016, 331 patients were included in the current study. Patients presented with unilateral T1b RCC and underwent either LPN (n = 177) or LRN (n = 154). Relevant clinical data including follow-ups were acquired from patients.

Results

The operation time of the LPN group patients was longer than that of LRN group (94.3 min vs 88.3 min, p = 0.021) and LPN group patients required shorter stays in hospital (11.5 days vs. 13.4 days, p = 0.009). Contrast to LRN, level of eGFR was superior in LPN at the postoperative time of 1 day, 3 months, 6 months, 12 months and 24 months (all p < 0.001). Kaplan–Meier plots and log-rank tests showed that patients undergoing LPN had a much higher overall survival (OS) (p = 0.007), cancer-specific survival (CSS) (p = 0.006) and metastasis-free survival (MFS) (p = 0.008) than those receiving LRN. In comparison with the LRN group, multivariable Cox analysis indicated that patients of the LPN group had a 1.9-fold OS, 2.9-fold CSS and 2.3-fold MFS.

Conclusions

For patients with T1b RCC, our findings revealed that OS, CSS and MFS are superior in patients receiving LPN than those treated with LRN. With the benefit of preserving renal function of LPN, which leads a less incidence risk of other systematic diseases, LPN may be the preferred option when condition permits for cases involving T1b RCC.

Keywords

T1b renal cell carcinoma Partial nephrectomy Radical nephrectomy Survival Renal function 

Notes

Funding

This research was financially supported by the Capital Science and Technology Leading Talent Project (Project number: Z181100006318007).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was approved by the Research Ethics Committee of Beijing Chaoyang Hospital (China). Each enrolled patient provided written informed consent.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Urology, National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingPeople’s Republic of China
  2. 2.Department of Urology, Zhongnan HospitalWuhan UniversityWuhanPeople’s Republic of China
  3. 3.Department of Urology, Beijing Chaoyang HospitalCapital Medical UniversityBeijingPeople’s Republic of China

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