Néphrectomie partielle pour les cancers du rein de plus de 4 cm

Nemr, Elie; Azar, Georges; Fakih, Fadi; Chalouhy, E; Moukarzel, M; Sarkis, Pierre; Khoury, Raghid El; Ayoub, N.; Merhej, Sleiman

doi:10.1016/s1166-7087(07)92297-6

Cited by 10 publications

(3 citation statements)

References 22 publications

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“…Several studies have suggested that the indications for PN can be safely expanded to include patients with RCC up to 7 cm (T1b tumors) [16-18]. Leibovich et al have reported 5-year CSS rates of 95% and 98% for patients with tumors measuring 4 to 7 cm and who underwent PN and RN, respectively [3].…”

Section: Discussionmentioning

confidence: 99%

Comparison of Partial and Radical Nephrectomy for pT1b Renal Cell Carcinoma

et al. 2010

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PurposePartial nephrectomy (PN) for patients with T1a renal cell carcinoma (RCC) has increasingly become accepted, although its role for patients with T1b RCC remains controversial. We retrospectively evaluated and then compared the oncologic and functional outcomes of patients with pT1b RCC who were treated with PN or radical nephrectomy (RN).Materials and MethodsA total of 70 patients who were diagnosed with pT1bN0M0 RCC between January 1995 and December 2004 were included. The 5-year overall survival (OS), the 5-year recurrence-free survival (RFS), and the 5-year cancer-specific survival (CSS) were compared between the groups. Preoperative and postoperative serum creatinine and estimated glomerular filtration rate (GFR) levels were analyzed to assess renal function.ResultsThe 5-year OS (92.3% vs. 87.8%, p=0.501), RFS (92.3% vs. 77.8%, p=0.175), and CSS (92.3% vs. 94.5%, p=0.936) of the PN and RN groups were not statistically different. The proportion of patients with decreased renal function was lower in the PN group than in the RN group (PN=0% vs. RN=11.5%). The postoperative change in serum creatinine and the GFR 1 year after nephrectomy was higher in the RN group than in the PN group (PN=0.2±0.2, 12.1±9.1 vs. RN=0.3±0.5, 18.1±12.5), but there was no statistical difference.ConclusionsThere were no statistically significant differences in prognosis or renal function between patients treated with PN and those treated with RN for pT1b RCC. PN may be a useful treatment modality for patients with pT1b RCC.

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Section: Discussionmentioning

confidence: 99%

Comparison of Partial and Radical Nephrectomy for pT1b Renal Cell Carcinoma

et al. 2010

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“…Il a ainsi pu être très récemment démontré dans une série multicentrique incluant plus de 700 NP électives que dans ce groupe hypersélectionné, il n'existait strictement aucune différence de survie spécifique entre les tumeurs inférieures et supérieures à 4 cm [19]. Depuis ces trois premières séries princeps, cinq autres séries ont confirmé les excellents résultats de la NP élective en terme de survie dans les tumeurs T1b (Tableau 1) [19][20][21][22][23][24]. Par exemple, Mitchell et al [20] ont apparié chacun de leurs 33 patients opé-rés d'une NP pour RCC T1b à deux patients ayant bénéficié d'une NE pour des RCC de même taille.…”

Section: Données Récentes Et éVolutions Des Conceptsunclassified

“…Pour leur part, Becker et al ont démontré l'excellent contrôle oncologique à très long terme de la NP pour les patients porteurs de tumeurs de plus de 4 cm, avec un taux de survie spéci-fique à 15 ans de 86,7 % [23]. Enfin, Nemr et al ont publié la série de comparaison NP versus NE la plus récente et ont conclu à l'absence d'influence de la taille sur la survie, pour des tumeurs jusqu'à 7 cm [24]. [26,27].…”

Section: Données Récentes Et éVolutions Des Conceptsunclassified

La taille tumorale limite-t-elle encore les indications de la néphrectomie partielle en 2008 ?

Crépel

Bensalah

Patard

2008

Progrès en Urologie

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Open partial nephrectomy: ancient art or currently available technique?

et al. 2015

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Renal cell carcinoma (RCC) accounts for 3 % of adult solid tumors, with the highest incidence between 50 and 70 years of age. Nephron-sparing surgery was initially reserved to patients with small renal masses detected in anatomically or functionally solitary kidney or in the presence of multiple bilateral tumors or hereditary forms of RCC, which posed a high risk of developing a tumor in the contralateral kidney. Nowadays, partial nephrectomy (PN) has grown up to an established approach for the treatment of small renal masses. In patients with T1a-staged RCCs, PN has proven to be associated with better survival, long-term renal function preservation with lower dialysis need or renal transplantation. Currently, most of the kidney masses are incidentally detected, up to 40 %, with smaller size due to the widespread use of imaging modalities such as ultrasound, computed tomography and magnetic resonance. Here we review the role of open PN in the management of small renal masses particularly focusing on indications, oncological outcomes and comparison with laparoscopic and robotic PN. Recent studies demonstrate that PN confers better survival, oncologic equivalence and lower risk of severe chronic kidney disease compared to radical nephrectomy becoming then the gold-standard surgical technique, even if increasingly challenged by laparoscopic and/or robot-assisted partial nephrectomy which in the hands of experts seems to achieve comparable outcome results albeit with slightly higher complication rate.

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Néphrectomie partielle pour les cancers du rein de plus de 4 cm

Cited by 10 publications

References 22 publications

Comparison of Partial and Radical Nephrectomy for pT1b Renal Cell Carcinoma

Comparison of Partial and Radical Nephrectomy for pT1b Renal Cell Carcinoma

La taille tumorale limite-t-elle encore les indications de la néphrectomie partielle en 2008 ?

Open partial nephrectomy: ancient art or currently available technique?

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