A meta-analysis for comparison of partial nephrectomy vs. radical nephrectomy in patients with pT3a renal cell carcinoma

Abstract

Background: Kidney cancer is the most common malignant tumor of the kidney in adults. However, in terms of the treatment for pT3a renal cell carcinoma (RCC), whether partial nephrectomy (PN) can be selected is still controversial. This study was conducted to compare the efficacy of PN and radical nephrectomy (RN) in treatment for patients with pT3a RCC. Methods:The relative English databases including PubMed and EMBASE were searched for studies comparing PN and RN for pT3a RCC between 2010 and 2020. Stata 13.0 software was used to compare the cancer-specific survival (CSS), overall survival (OS), cancer-specific mortality (CSM), relapse-free survival (RFS), complications and positive surgical margin.Results: Nine articles were included with a total of 3,391 patients, of whom 2,113 received RN and 1,278 received PN. The results showed that there is no statistical difference in CSS, OS, CSM, RFS, complications and positive surgical margin between RN and PN. No heterogeneity was shown in study.Conclusions: There were no differences in the CSS, OS, CSM, RFS, complications and positive surgical margin of the patients in RN and PN group. For pT3a RCC, RN did not provide a better survival benefit compared to PN. Considering PN can suppress the progression of tumor and reduce the risk of postoperative chronic renal insufficiency, we found PN is a good choice for pT3a RCC. However, further large-sample, studies are still needed in future.

Clinical and pathological characteristics of completely endophytic renal cell carcinoma

“…In our study, all six patients with T3 stage CERCC underwent radical nephrectomy. A recent meta-analysis showed no difference in cancer-speci c survival, OS, cancer-speci c mortality, and recurrence-free survival between partial nephrectomy and radical nephrectomy in patients with pT3a RCC [22]. However, the safety and e cacy of partial nephrectomy in patients with T3 stage CERCCs need to be further con rmed by studies in the future with large sample sizes.…”

Long Non-Coding RNAs as Novel Biomarkers in the Clinical Management of Papillary Renal Cell Carcinoma Patients: A Promise or a Pledge?

“…PN is feasible also for >4 cm lesions limited to the kidney because of a lower likelihood of tumor recurrence, cancer-specific and all-cause mortality, but it should be used in selected patients because of the higher hemorrhagic risk and likelihood of complications [116]. A recent meta-analysis reported that PN and radical nephrectomy (RN) in patients with pT3a RCC showed similar results, with no differences in cancerspecific mortality, overall survival (OS), cancer-specific survival, relapse-free survival, complications and positive surgical margin, but these findings need to be confirmed by larger prospective studies [117].…”