BACKGROUND: The aim of this study was to test for differences in cancer specific mortality (CSM) rates between radical nephrectomy (RN) and partial nephrectomy (PN) in pT3a nmRCC patients.METHODS: Within the surveillance, epidemiology, and end results database (2005-2016), 13,177 pT3a patients treated with either PN or RN were identified. Before and after 1:2 ratio propensity score (PS)-match between PN and RN patients, cumulative incidence plot and competing risks regression (CRR) were used to test differences in CSM and other cause mortality (OCM) rates.RESULTS: Relative to PN (N.=1615, 22.5%), RN patients harbored higher tumor size (72 vs. 38 mm; >70 mm 51 vs.10%), of more aggressive histology, collecting duct (0.4 vs. 0.2%) and sarcomatoid (2.3 vs.0.8%), of higher grade (51.0 vs. 37.5%). After PS-matching and OCM adjustment, 5-year CSM was 3-fold higher after RN than PN (P<0.01). Similarly, after PS matching and CSM adjustment, also 5-year OCM rates were higher after RN (HR: 1.59, P=0.0003).CONCLUSIONS: PN does not appear to compromise the oncological outcomes in patients with pT3a or high-grade renal masses when compared with RN. Therefore, these concerns should not deter a surgeon from attempting PN when otherwise technically feasible.

Partial vs. radical nephrectomy in non-metastatic pT3a kidney cancer patients: a population-based study

Pecoraro, Angela;Amparore, Daniele;Manfredi, Matteo;Piramide, Federico;Checcucci, Enrico;Peretti, Dario;Fiori, Cristian;Porpiglia, Francesco
2022-01-01

Abstract

BACKGROUND: The aim of this study was to test for differences in cancer specific mortality (CSM) rates between radical nephrectomy (RN) and partial nephrectomy (PN) in pT3a nmRCC patients.METHODS: Within the surveillance, epidemiology, and end results database (2005-2016), 13,177 pT3a patients treated with either PN or RN were identified. Before and after 1:2 ratio propensity score (PS)-match between PN and RN patients, cumulative incidence plot and competing risks regression (CRR) were used to test differences in CSM and other cause mortality (OCM) rates.RESULTS: Relative to PN (N.=1615, 22.5%), RN patients harbored higher tumor size (72 vs. 38 mm; >70 mm 51 vs.10%), of more aggressive histology, collecting duct (0.4 vs. 0.2%) and sarcomatoid (2.3 vs.0.8%), of higher grade (51.0 vs. 37.5%). After PS-matching and OCM adjustment, 5-year CSM was 3-fold higher after RN than PN (P<0.01). Similarly, after PS matching and CSM adjustment, also 5-year OCM rates were higher after RN (HR: 1.59, P=0.0003).CONCLUSIONS: PN does not appear to compromise the oncological outcomes in patients with pT3a or high-grade renal masses when compared with RN. Therefore, these concerns should not deter a surgeon from attempting PN when otherwise technically feasible.
2022
74
4
445
451
Mortality; Carcinoma, renal cell; Nephrectomy; Humans; Nephrectomy; Propensity Score; Treatment Outcome; Carcinoma, Renal Cell; Kidney Neoplasms
Pecoraro, Angela; Amparore, Daniele; Manfredi, Matteo; Piramide, Federico; Checcucci, Enrico; Tian, Zhe; Peretti, Dario; Fiori, Cristian; Karakiewicz, Pierre I; Porpiglia, Francesco
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1881168
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