A Non–Cancer-Related Survival Benefit Is Associated With Partial Nephrectomy

Sun, Maxine; Trinh, Quoc Dien; Bianchi, Marco; Hansen, Jens; Hanna, Nawar; Abdollah, Firas; Shariat, Shahrokh F.; Briganti, Alberto; Montorsi, Francesco; Perrotte, Paul; Karakiewicz, Pierre I.

doi:10.1016/j.eururo.2011.11.047

Cited by 125 publications

(77 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…1,4,5 The understanding of increased risk of chronic kidney disease (CKD) with radical nephrectomy as well as recent data highlighting the association between CKD and cardiovascular morbidity and mortality have led to the desire to preserve as much normal renal parenchyma as possible. 6 Several factors are thought to impact postoperative renal function, including patient-related factors such as age, comorbidities, and preoperative renal function.…”

Section: Discussionmentioning

confidence: 99%

Factors That Affect Proportional Glomerular Filtration Rate After Minimally Invasive Partial Nephrectomy

Hakimi

Ghavamian

Williams

et al. 2013

Journal of Endourology

View full text Add to dashboard Cite

Background and Purpose: Several factors have been shown to impact the overall glomerular filtration (GFR) rate after partial nephrectomy. Change in overall GFR, however, does not necessarily reflect the impact of these factors on the operated kidney. Using preoperative and postoperative renal scintigraphy, we sought to assess the impact of patient, tumor, and operative factors on GFR of the affected kidney (proportional GFR). Patients and Methods: We identified 73 patients who underwent minimally invasive partial nephrectomy with preoperative and postoperative renal scans from two institutions. Patient, tumor, and operative characteristics were recorded. We used multiple linear regression to determine the patient and clinical factors predictive of postoperative proportional GFR in the operated kidney. We tested for an interaction between preoperative proportional GFR and nephrometry score and ischemia. We further fitted two separate linear models to compare the proportion of variance (R 2 ) explained by ischemia time in change in renal function in the operated kidney with the change in renal function in both kidneys. Results: Surgical parameters (procedure approach, ischemia time, and estimated blood loss) and preoperative proportional GFR were significantly associated with postoperative proportional GFR. Preoperative proportional GFR (b = 5.93, 95% confidence interval [CI]: 3.88, 7.97, P < 0.0005) and procedure approach (b = 8.67, 95% CI: 4.50, 12.80, P < 0.0005) were strongly associated with outcome while ischemia time (b = -1.80, 95% CI: -3.48, -0.11, P = 0.04) and estimated blood loss (b = -1.15, 95% CI: -0.29, -0.01, P = 0.04) just reached statistical significance. The interaction term between preoperative proportional GFR and nephrometry score or ischemia time was not statistically significant (nephrometry, P = 0.2 continuous or P = 0.6 categorical, and ischemia, P = 0.7, respectively). Conclusion: Lower preoperative proportional GFR, longer ischemia times, and higher blood loss all negatively impact postoperative proportional GFR while tumor complexity as gauged by morphometry scoring does not. Larger studies are needed to determine whether renal scintigraphy is a more accurate method of measuring the impact of the ischemia time on postoperative proportional GFR.

show abstract

Section: Discussionmentioning

confidence: 99%

Factors That Affect Proportional Glomerular Filtration Rate After Minimally Invasive Partial Nephrectomy

Hakimi

Ghavamian

Williams

et al. 2013

Journal of Endourology

View full text Add to dashboard Cite

show abstract

“…The role of partial nephrectomy (PN) in the management of small renal masses (SRMs) remains controversial; however, the significant prevalence of chronic kidney disease (CKD) and its associated morbidity argue in favor of nephronsparing approaches [1][2][3][4]. The adoption of laparoscopic and robotic PN has been propelled by equivalent oncologic and functional outcomes compared with the open approach [5].…”

Section: Introductionmentioning

confidence: 99%

Robotic Unclamped “Minimal-margin” Partial Nephrectomy: Ongoing Refinement of the Anatomic Zero-ischemia Concept

Satkunasivam¹,

Tsai²,

Syan³

et al. 2015

European Urology

View full text Add to dashboard Cite

“…Equal oncologic outcome [1-4] could be shown by both surgical treatments with, for example, an increase in overall mortality and non-cancer-related death rates in patients treated by nephrectomy [5-7]. Consequently, international guidelines were adapted regarding the recommendations of surgical treatment in pT1 RCC.…”

Section: Introductionmentioning

confidence: 99%

The Overall Survival Benefit for Patients with T1 Renal Cell Carcinoma after Nephron-Sparing Surgery Depends on Gender and Age

et al. 2018

View full text Add to dashboard Cite

Due to the recommendations in the urological guidelines to perform nephron-sparing surgery in patients with organ-confined renal cell carcinoma (RCC), the customary therapy regimen changed, but it is not well studied yet whether partial nephrectomy (PN) especially in the elderly is beneficial. From 2000 to 2015, 3,592 patients from 7 clinics undergoing surgery in RCC were identified; 2,323 had T1 tumours. We retrospectively compared the overall survival benefit of patients with T1 RCC who underwent either PN or radical nephrectomy (RN) and studied effects of age and gender. Results: In T1 RCC, PN was beneficial in male patients (p = 0.0006) independent of age, especially in those men ≤75 years of age (p = 0.0005); but PN was not beneficial for female patients (p = 0.0629) regardless of age and male patients older than 75 years (p = 0.736). The OS of female patients after RN and male patients after PN is the same, regardless of age. A life expectancy of more than 45 months at least is necessary to experience an overall survival benefit after PN. Conclusions: There should be harder proven indications for PN in female patients and especially in all patients older than 75 years, particularly with regard to perioperative risk factors.

show abstract

A Non–Cancer-Related Survival Benefit Is Associated With Partial Nephrectomy

Cited by 125 publications

References 26 publications

Factors That Affect Proportional Glomerular Filtration Rate After Minimally Invasive Partial Nephrectomy

Factors That Affect Proportional Glomerular Filtration Rate After Minimally Invasive Partial Nephrectomy

Robotic Unclamped “Minimal-margin” Partial Nephrectomy: Ongoing Refinement of the Anatomic Zero-ischemia Concept

The Overall Survival Benefit for Patients with T1 Renal Cell Carcinoma after Nephron-Sparing Surgery Depends on Gender and Age

Contact Info

Product

Resources

About