Renal Cancer Surgery for Patients without Preexisting Chronic Kidney Disease: Is there a Survival Benefit for Elective Partial Nephrectomy?
Retrospective studies suggest that partial nephrectomy (PN) provides improved survival compared to radical nephrectomy (RN), even when performed electively. However, selection bias may be contributing and further investigation is required. We evaluated factors associated with non-renal cancer-related survival (NRCS) after PN or RN for patients with preoperative GFR ≥60ml/min/1.73m2.
Our study represents a single-center, retrospective evaluation of 3,133 patients (1997-2008) with preoperative GFR ≥60ml/min/1.73m2 managed with PN or RN, with PN performed in 1,732 (55%) cases. NRCS was analyzed by Kaplan-Meier in various cohorts based on functional parameters including preoperative GFR and new baseline GFR but also by procedure (PN versus RN). Cox proportional hazards assessed factors associated with NRCS among patients with new baseline GFR ≥45ml/min/1.73m2.
Median age was 59 years and 60% of patients were male. Median preoperative GFR was 85 ml/min/1.73m2 in both the PN and RN cohorts. New baseline GFR after RCS was 80 ml/min/1.73m2 for PN and 63 ml/min/1.73m2 for RN (p