Impact of Reduced Glomerular Filtration Rate and Proteinuria on Overall Survival of Patients with Renal Cancer

Abstract

Preoperative proteinuria is a significant predictor of overall survival in patients who undergo nephrectomy. Classification according to preoperative glomerular filtration rate and proteinuria more accurately predicts survival than using the glomerular filtration rate alone after accounting for cancer stage. This information supports routine evaluation of proteinuria in patients with kidney cancer.

Impact of preoperative proteinuria on renal functional outcomes after open partial nephrectomy in patients with a solitary kidney

“…Recently, several articles have been published concerning the negative impact of proteinuria on postoperative renal function. Tourojman et al [ 5 ] reported that preoperative proteinuria as well as preoperative GFR is a significant predictor of overall survival, independent of cancer stage. In their study, 362 and 538 patients received partial and radical nephrectomy, respectively.…”

“…The decreased overall survival was presumably due to cardiovascular disease predisposed by CKD stage progression, although the specific course of GFR decline after surgery was not provided. They concluded that precise staging of CKD with GFR and the extent of proteinuria should be considered when assessing prognosis and treatment strategy [ 5 ]. Currently, the number of cases treated with robot-assisted partial nephrectomy (RAPN) is increasing, and the impact of proteinuria on renal function has also been studied among patients treated with RAPN.…”

“…An international work group has classified stages of chronic kidney disease (CKD), which are based on the cause, glomerular filtration rate (GFR), and albuminuria [ 4 ]. Preoperative proteinuria as well as GFR reportedly impact overall survival of patients undergoing nephrectomy [ 5 ]. CKD is more likely to progress in patients who have CKD due to medical reasons compared to those who have the same degree of CKD caused by NSS [ 6 ].…”

Trends in Percutaneous Thermal Ablation Therapies in the Treatment of T1a Renal Cell Carcinomas Rather than Partial Nephrectomy/Radical Nephrectomy

“…comparable therapeutic data to identify the potential efficacy differences among available multiple RCCs management modalities in long-term follow-up. 7,10,24,33,[42][43][44][45][46][47][48][49][50][51][52][53][54][55] In a 2019 study, Palumbo et al evaluated 3,946 patients using the Surveillance, Epidemiology and End Results database (SEER, 2004-2015) treated with cryosurgery for T1a lesions, reporting that tumor size greater than 3 cm is an independent predictor of higher 5-year cancer-specific mortality rate. Therefore, they suggested the local tumor ablation should be performed for tumors less than 3 cm.…”

“…Therefore, they suggested the local tumor ablation should be performed for tumors less than 3 cm. 43 As with all ablative sites, tumor diameter is the key predictive factor for local tumor control with larger lesions greater than 3 cm having greater likelihood of incomplete ablation and local recurrence 3,51 (►Table 1).…”