Partial Nephrectomy for T1b/T2 Renal Mass

Abstract

The aim of our study was to show our short-term experience in managing large renal masses (cT1b/T2) through partial nephrectomy (PN) over the last 3 years. Retrospective data collection for all patients managed by PN for renal masses larger than 4 cm over the last 3 years. Epidemiological data were collected. Surgical data including surgical and ischemic times as well as intra and postoperative complications were collected. Pre- and postoperative estimated glomerular filtration rate (eGFR) data were collected and correlated as well as postoperative complications and recurrence. We could identify 47 patients managed by PN for radiologically confirmed >4 cm renal masses. The mean age of the patients was 55.7 ± 13.4, including 29 males and 18 females. Masses were T1b and T2 in 40 and 7 patients, respectively. The mean tumor size was 6.2 ± 1.5 cm. Using renal nephrometry score; 8, 28, and 11 had low, moderate, and high complexity, respectively. Renal cell carcinoma (RCC) was identified in 42 patients. Five patients out of 42 cancerous cases (12%) had pathological T3 RCC. The mean preoperative and postoperative eGFR were 89.09 ± 12.41 and 88.50 ± 10.50, respectively (P 0.2). The median follow-up was 14 months and within that short time, no patient had evidence for cancer recurrence. PN for large renal masses is safe in experienced hands and should be attempted in a higher percentage of patients, regardless of the tumor complexity. No cancer recurrence or deterioration of renal function was observed within our short-term follow-up.

The Evolution of Tumor Enucleation Partial Nephrectomy: A Comparison of Perioperative Outcomes for Sutureless Hemostatic Bandage as an Alternative to Standard Renorrhaphy

“…PN has also been demonstrated to be a safe and effective means of obtaining oncologic control for T1b lesions and even appropriately selected larger, exophytic lesions. (2,3,4) Most surgeons utilize a standard margin partial nephrectomy technique in which a rim of healthy parenchyma around the mass is sacri ced to obtain a negative surgical margin. However, concerns have been raised by this loss of healthy parenchyma contributing to renal function decline and development of CKD in some patients.…”