Partial versus radical nephrectomy in pT2a renal cell carcinoma tumors: which is the superior surgical approach?

Abstract

Abstract Background Controversy persists regarding the superiority of partial nephrectomy (PN) versus radical nephrectomy (RN) in pT2a renal cell carcinoma (RCC) tumors. In this study we aimed to compare survival and clinical outcomes between these two techniques in Iran. Methods In this retrospective cohort, 96 patients who underwent either RN or PN for their pT2a RCC tumors were included. Overall survival (OS), cancer specific survival (CSS), recurrence free survival (RFS), major postoperative complications and postoperative renal function were compared, subsequently. Results During a mean follow-up time of 57.3 ± 24.0 months, OS, CSS, RFS, postoperative bleeding, postoperative urinary leak, postoperative prolonged wound drainage and length of hospital stay were not statistically different between RN versus PN patients (p = .09, .42, .09, .27, .27, .06 and .78, respectively). Nevertheless, post-operative creatinine was significantly lower in PN patients compared to RN patients (p = .01). Our multivariable cox regression models indicated that higher Fuhrman grade detrimentally affected CSS (p < .01) and increased the risk of recurrence (p = .02). Moreover, prior history of ischemic heart disease (IHD) was a significant determinant of lower OS (p = .03) and RFS (p = .02). Conclusions In conclusion, our data suggested that although OS, CSS, RFS and major postoperative complications were similar between PN and RN, PN may offer better postoperative renal function and can be thus regarded as the superior approach in pT2a tumors.

Keywords

• Kidney neoplasms
• Partial nephrectomy
• Radical nephrectomy
• Renal cell carcinoma
• Survival analysis