OncologyAssessment of Cancer Control Outcomes in Patients With High-risk Renal Cell Carcinoma Treated With Partial Nephrectomy
Section snippets
Data Source
The study cohort consisted of patients diagnosed with RCC (C67.0-C67.9) from the Surveillance, Epidemiology, and End Results (SEER) database reported by the National Cancer Institute statistics program, from 1988 to 2008. The SEER routinely collects patient demographics and publishes cancer incidence and survival data from population-based cancer registries covering approximately 26% of the U.S. population.
Study Population
The data from patients with a primary diagnosis of nonmetastatic clear cell, chromophobe,
Results
Overall, 8847, 11 547, and 5232 patients had tumors >7 cm, high-grade RCC, and pT3a lesions, respectively. The results are illustrated for each of the 3 separate subcohorts.
Comment
Several studies have confirmed the equivalence of cancer control outcomes between PN and RN in patients with Stage T1a and T1b RCC.5, 6, 7, 8, 9, 10 Additionally, multiple reports have confirmed the superiority of renal function preservation and overall survival when PN is performed instead of RN.2, 3, 4, 13, 22, 23, 24, 25 Based on these facts, contemporary guidelines have suggested PN for patients with Stage pT1a and some select patients with pT1b lesions, when renal function preservation is
Conclusions
Even in patients with adverse pathologic features, PN does not compromise oncologic outcomes, such as CSM. This implies that when functional considerations require PN in patients with high-risk features, the decision to perform PN should not depend on stage or grade, but rather on the technical ability to remove the tumor with a negative margin and provide sufficient functional renal remnant.
References (26)
- et al.
Age-adjusted incidence, mortality, and survival rates of stage-specific renal cell carcinoma in North America: a trend analysis
Eur Urol
(2011) - et al.
Partial nephrectomy is associated with improved overall survival compared to radical nephrectomy in patients with unanticipated benign renal tumours
Eur Urol
(2010) - et al.
A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma
Eur Urol
(2011) - et al.
Nephron-sparing surgery is equally effective to radical nephrectomy for T1BN0M0 renal cell carcinoma: a population-based assessment
Urology
(2010) - et al.
Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy
J Urol
(2004) - et al.
Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger
Urology
(2006) - et al.
Safety and efficacy of partial nephrectomy for all T1 tumors based on an international multicenter experience
J Urol
(2004) - et al.
Oncologic long-term outcome of elective nephron-sparing surgery versus radical nephrectomy in patients with renal cell carcinoma stage pT1b or greater in a matched-pair cohort
Urology
(2011) - et al.
The use of partial nephrectomy in European tertiary care centers
Eur J Surg Oncol
(2009) - et al.
A non-cancer-related survival benefit is associated with partial nephrectomy
Eur Urol
(2012)
Guideline for management of the clinical T1 renal mass
J Urol
Outcome of stage T2 or greater renal cell cancer treated with partial nephrectomy
J Urol
Partial nephrectomy does not compromise survival in patients with pathologic upstaging to pT2/pT3 or high-grade renal tumors compared with radical nephrectomy
Urology
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Financial Disclosure: The authors declare that they have no relevant financial interests.
Financial Support: P. I. Karakiewicz is partially supported by the University of Montréal Health Centre Urology Specialists, Fonds de la Recherche en Sante du Quebec, University of Montréal Department of Surgery, and University of Montréal Health Centre Foundation.