Safety and Efficacy of Partial Nephrectomy for All T1 Tumors Based on an International Multicenter Experience

Patard, Jean‐Jacques; Shvarts, Oleg; Lam, John S.; Pantuck, Allan J.; KIM, HYUNG L.; Ficarra, Vincenzo; Cindolo, Luca; Han, Kyung Joon; Taille, Alexandre de la; Tostain, Jacques; Artibani, Walter; Abbou, Claude C.; Lobel, Bernard; Chopin, Dominique; Figlin, Robert A.; Mulders, Peter F.A.; Belldegrun, Arie S.

doi:10.1097/01.ju.0000124846.37299.5e

Cited by 535 publications

(280 citation statements)

References 16 publications

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“…The survival outcome for tumors < 7 cm that were re-resected by radical nephrectomy is similar; however, the possibility of RCC recurrence varies from 2.6% to 9% in T1a and T1b tumors, respectively (11). In this study, we found that the average survival of patients with T1a tumors was 91%, while in T1b tumors, 79% were free from the disease in 5 years.…”

Section: Commentssupporting

confidence: 50%

The beginning of the 21st century: a paradigm shift in the surgical management of renal cell carcinoma in South America

Dall’Oglio

Crippa²,

Câmara³

et al. 2010

Int. braz j urol.

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Purpose: The incidence of renal cell carcinoma (RCC) has been rising by 2.3 to 4.3% every year over the past three decades. Previously, RCC has been known as the internist's tumor; however, it is now being called the radiologist's tumor because 2/3 are now detected incidentally on abdominal imaging. We compared patients who were treated toward the end of the 20th century to those treated during the beginning of the 21st century with regard to RCC size and type of surgical treatment. Materials and Methods:The study included 226 patients. For analysis of tumor size, we considered a cut point of < 4 cm and > 4 cm. For analysis of type of surgery performed, we considered radical and partial nephrectomy. Results: After the turn of the century, there was a reduction of 1.57 ± 0.48 cm in the size of the RCC that was operated on. Nephron sparing surgeries were performed in 17% of the cases until the year 2000, and 39% of the tumors were < 4 cm. From 2001, 64% of the tumors measured < 4 cm and 42% of the surgeries were performed using nephron sparing techniques. Mean tumor size was 5.95 cm (± 3.58) for the cases diagnosed before year 2000, and cases treated after the beginning of 21st century had a mean tumor size of 4.38 cm (± 3.27). Conclusions: Compared with the end of the 20th century, at the beginning of the 21st century due to a reduction in tumor size it was possible to increase the number of nephron sparing surgeries.

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Section: Commentssupporting

confidence: 50%

The beginning of the 21st century: a paradigm shift in the surgical management of renal cell carcinoma in South America

Dall’Oglio

Crippa²,

Câmara³

et al. 2010

Int. braz j urol.

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“…The 5-year overall survival rates of the partial nephrectomy and radical nephrectomy groups were 89.3% and 84.4%, respectively and the 10-year overall survival rates were 71.3% and 68.2% in favour of partial nephrectomy [34] (Zini 2009b) ( Table 2). Thompson (2008) [35] reported data from the Mayo clinic institutional databases and found no evidence that radical and partial nephrectomy were different in terms of all cause death: RR In a subset of T1b patients (i.e.4-7cm), Patard (2004) [37] noted no difference in cancer specific survival at 5 years (log rank test p = 0.8) in a multi-institutional study. There were no statistically significant differences in partial vs. radical nephrectomy respectively in local (1/28 vs. 5/218) or distant (8/28 vs. 34/218) recurrence at a mean follow-up of 62.5 months.…”

Section: Iiia Open or Laparoscopic Partial Nephrectomy Vs Open Or mentioning

confidence: 99%

“…Huang (2009) [33], Zini (2009b) [34], Thompson (2008) [35] and Patard (2004) [36] studied small renal tumours. Huang (2009) [33] and Zini (2009b) [34] both report data from the SEER database.…”

Section: Iiia Open or Laparoscopic Partial Nephrectomy Vs Open Or mentioning

confidence: 99%

Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer

MacLennan

Imamura

Lapitan³

et al. 2012

European Urology

300

174

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Context: Renal cell carcinoma (RCC) accounts for 2-3% of adult malignancies. There remain uncertainties over the oncological outcomes for the surgical management of localised RCC. Objective: To systematically review relevant literature comparing oncological outcomes of surgical management of localised RCC (T1-2N0M0). Evidence Acquisition: Relevant databases including MEDLINE, Embase and the Cochrane Library were searched up to October 2010, and an updated scoping search was performed up to January 2012. Randomised or quasi-randomised controlled trials (RCTs), prospective observational studies with controls, retrospective matched-pair studies, and comparative studies from well defined registries/databases were included. The main outcomes were overall survival, cancer-specific survival, recurrence and metastases. The Cochrane risk of bias (RoB) tool was used to assess RCTs and an extended version was used to assess Non Randomised Studies (NRS). The quality of evidence was assessed using GRADE. Evidence Synthesis: 4580 abstracts and 389 full text articles were assessed. 34 studies met the inclusion criteria (6 RCTs and 28 NRSs). Meta-analyses were planned but were deemed inappropriate due to data heterogeneity. There were high risks of bias and low quality evidence across the evidence base. Open radical nephrectomy and open partial nephrectomy showed similar cancer-specific and overall survival, but when both open and laparoscopic approaches are considered together the evidence showed improved survival for partial nephrectomy for tumours ≤4cm.Overall, the evidence suggests either equivalent or better survival with partial nephrectomy. Laparoscopic radical nephrectomy offered equivalent survival to open radical nephrectomy, and all laparoscopic approaches achieved equivalent survival. Open and laparoscopic partial nephrectomy achieved equivalent survival. The issue of ipsilateral adrenalectomy or complete lymph node dissection with radical nephrectomy or partial nephrectomy remains unresolved. Conclusions: The evidence base suggests localised RCC are best managed by nephron sparing surgery where technically feasible. However, the current evidence base has significant limitations due to studies of low methodological quality marked by high risks of bias.

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“…In this scenario, renal preservation has been progressively prioritized, as approximately 26% of patients have impaired renal function prior to undergoing either NSS or radical nephrectomy (RN) and RN is a recognized independent risk factor in the development of chronic kidney disease postoperatively, cardiovascular events and overall mortality [7]. [10][11][12][13][14]. Due to its wide use and acceptance, open NSS remains the contemporary cornerstone in the management of small renal masses, performed either as partial nephrectomy (PN) or tumor enucleation (TE), which is a tumorectomy performed by a blunt dissection, using the natural cleavage plane between the tumor and normal parenchyma, with no ablation of the tumor bed [15][16][17][18][19].…”

mentioning

confidence: 99%

The safety and efficacy of sonidegib for the treatment of locally advanced basal cell carcinoma

Collier

Ali

Lear

2016

Expert Review of Anticancer Therapy

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Safety and Efficacy of Partial Nephrectomy for All T1 Tumors Based on an International Multicenter Experience

Cited by 535 publications

References 16 publications

The beginning of the 21st century: a paradigm shift in the surgical management of renal cell carcinoma in South America

The beginning of the 21st century: a paradigm shift in the surgical management of renal cell carcinoma in South America

Systematic Review of Oncological Outcomes Following Surgical Management of Localised Renal Cancer

The safety and efficacy of sonidegib for the treatment of locally advanced basal cell carcinoma

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