Partial nephrectomy versus radical nephrectomy for clinical localised renal masses

Abstract

Partial nephrectomy may be associated with a decreased time-to-death of any cause. With regards to surgery-related mortality, cancer-specific survival and time-to-recurrence, partial nephrectomy appears to result in little to no difference.

Age at diagnosis and the surgical management of small renal carcinomas: findings from a cross‐sectional population‐based study

“…Survival analyses that focused on data only for RCC cases found no difference between treatment arms . Findings from observational studies and matched case–control studies have suggested greater benefits of PN both in terms of kidney function and survival ; however, concerns regarding the quality of the RCT and the non‐randomized nature of observational studies have created some controversy regarding the role of PN in the treatment of small renal tumours . Queensland clinicians’ lower endorsement of PN as the treatment of choice for all T1a tumours may reflect the lack of certainty regarding the benefits of PN, particularly for older patients.…”

Case ‒ Laparoscopic transperitoneal partial nephrectomy of T3a renal cell carcinoma within a horseshoe kidney

“…Comparative series have demonstrated that partial nephrectomies are non-inferior to radical nephrectomies with respect to oncological results and provide additional benefits to the patient. 7 Evidence continues to accumulate that laparoscopic and robotic…”

Partial Nephrectomy is the Surgical Treatment of Choice for (Most) Complex Localized Renal Tumors

“…PN is generally considered a more technically complex approach that is more time-consuming and may be associated with an increased rate of surgical complications [1,27]. The risk for common perioperative and postoperative complications such as bleeding (relative risk (RR) 1.94) and urinary fistula (RR 20.92) was significantly increased for PN compared to RN, with no difference in re-operation rates in a recent Cochrane review including all stages of disease [28]. Supporting these findings, in a systematic review focusing on pT1b and T2 tumors, the likelihood of postoperative complications was higher for the PN group (OR 1.74).…”