Renal function after nephron-sparing surgery versus radical nephrectomy in localized renal cell carcinoma (T1)

Authors

  • Siros Jitpraphai Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Chaiyong Naulyong Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Tawatchai Taweemonkongsap Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sithiporn Srinualnud Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Teerapon Amornwechsugich Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Sunai Leewansangtone Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Bansithi Chaiyaprasithi Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Ekkarin Chotikawanich Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Kittipong Phinthusophon Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Chalairat Suk-ouichai Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Varat Woranisaragul Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
  • Phanpon Leelahawong Division of Urology, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

Keywords:

Renal function, radical nephrectomy, partial nephrectomy, renal cell carcinoma

Abstract

Objective:  To evaluate renal function (GFR) after radical nephrectomy compared to partial nephrectomy in stage T1 renal cell carcinoma patients between 2005
and 2015.

Material and Method:  Retrospective chart review of 409 patients who were diagnosed with renal cell carcinoma (T1) and treated with radical nephrectomy
(RN) or partial nephrectomy (PN) between 2005 and 2015 (RN=136, PN=92); 228 patients with pathologically confirmed pT1 remained for analysis and were then
evaluated for their estimated glomerular filtration rate (eGFR) after the surgery.

Results:  There were a total of 228 (149 males and 79 females) T1 RCC patients; 136 patients were T1a with RN (57.8%) and 92 with PN (42.2%). Median follow-up
was 58 months and 35 months for the RN and PN groups. From the analysis, postoperative eGFR of the RN group was decreased from 77.49 to 59.61 ml/min/1.73
m2 and the PN group was decreased from 78.85 to 69.9 ml/min/1.73 m2. The comparative eGFR between the 2 groups at 1 month had a significant difference
(p-value<0.05). eGFR at 3 months (50.24 in RN vs 64.67 in PN), 6 months (47.98 vs 64.51), 3 years (48.79 vs 67.22) and 5 years (52.63 vs 73.59) were also significantly altered between the 2 groups. The tumor recurrence rate was not significantly different between RN and PN.

Conclusion:  We found that patients treated with PN had superior post-operative renal function compared with RN. However, there was no difference in the tumor recurrence rate between the 2 groups after a follow-up of 10 years.

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Published

2020-12-02

How to Cite

Jitpraphai, S., Naulyong, C., Taweemonkongsap, T., Srinualnud, S., Amornwechsugich, T., Leewansangtone, S., Chaiyaprasithi, B., Chotikawanich, E., Phinthusophon, K., Suk-ouichai, C., Woranisaragul, V., & Leelahawong, P. (2020). Renal function after nephron-sparing surgery versus radical nephrectomy in localized renal cell carcinoma (T1). Insight Urology, 41(2), 1–8. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/247831

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