The safety and efficacy of nephron sparing surgery in T1N0M0 renal cell carcinoma

Background: Renal cell carcinoma (RCC) accounts for approximately 3% of adult malignancies and 90-95% of neoplasm arising from the kidney. Objective was to explore the safety and efficacy of nephron sparing surgery (NSS) for T1N0M0 renal cell carcinomas (RCC) and to assess the oncological outcome of NSS in T1N0M0 RCC.Methods: A total of 31 cases were enrolled for the study of which 11 (35.5%) underwent NSS and 20 (64.5%) underwent radical nephrectomy (RN). The clinical results were followed up and comparatively analyzed.Results: NSS was performed using a margin of 1cm, no positive surgical margin was detected. The mean blood loss and mean duration of surgery in NSS and RN was comparable. Among all one patient from NSS group experienced urinary leak which was managed by placement of DJ stent. The overall complication rate was 9.1% in NSS. Lab. tests before surgery and after surgery at 6month was done in the both groups and results obtained was within normal limits. Only one patient developed metastasis from NSS group and died at 14th month of fallow-up, whereas neither metastasis nor mortality were recorded in RN group.Conclusions: Nephron sparing SURGERY has proven to be a safe and effective approach for Renal cell carcinoma with comparable clinical results to radical nephrectomy especially in tumour ≤4cm.

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Faculty Opinions recommendation of A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.8848956.9392054 ◽

2011 ◽

Author(s):

Alessandro Volpe

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Oncologic Outcome ◽

Nephron Sparing Surgery ◽

Phase 3 ◽

Nephron Sparing

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Does a Positive Surgical Margin after Nephron Sparing Surgery Affect Oncological Outcome in Renal Cell Carcinoma? A Systematic Review and Meta-Analysis

Urology ◽

10.1016/j.urology.2021.04.058 ◽

2021 ◽

Author(s):

Nizar Hakam ◽

Nassib Abou Heidar ◽

Joanne Khabsa ◽

Layal Hneiny ◽

Elie A. Akl ◽

...

Keyword(s):

Systematic Review ◽

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Meta Analysis ◽

Surgical Margin ◽

Oncological Outcome ◽

Nephron Sparing Surgery ◽

Positive Surgical Margin ◽

Nephron Sparing

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Re: Hendrik Van Poppel, Luigi Da Pozzo, Walter Albrecht, et al. A Prospective, Randomised EORTC Intergroup Phase 3 Study Comparing the Oncologic Outcome of Elective Nephron-Sparing Surgery and Radical Nephrectomy for Low-Stage Renal Cell Carcinoma. Eur Urol 2011;59:543–52

European Urology ◽

10.1016/j.eururo.2011.05.009 ◽

2011 ◽

Vol 60 (2) ◽

pp. e9 ◽

Cited By ~ 3

Author(s):

Raguram Ganesamoni ◽

Ravimohan Mavuduru ◽

Mayank Mohan Agarwal

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Oncologic Outcome ◽

Nephron Sparing Surgery ◽

Phase 3 ◽

Nephron Sparing

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Comparison of Long-Term Results After Nephron-Sparing Surgery and Radical Nephrectomy in Treating 4- to 7-cm Renal Cell Carcinoma

Medicina ◽

10.3390/medicina49050036 ◽

2013 ◽

Vol 49 (5) ◽

pp. 36 ◽

Cited By ~ 3

Author(s):

Daimantas Milonas ◽

Giedrius Skulčius ◽

Ruslanas Baltrimavičius ◽

Stasys Auškalnis ◽

Marius Kinčius ◽

...

Keyword(s):

Renal Cell Carcinoma ◽

Cell Carcinoma ◽

Renal Cell ◽

Radical Nephrectomy ◽

Nephron Sparing Surgery ◽

Rank Test ◽

Cancer Specific Survival ◽

Log Rank Test ◽

Nephron Sparing

Objective. The aim of our study was to compare long-term oncological outcomes following nephron-sparing surgery (NSS) and radical nephrectomy (RN) for renal cell carcinoma (RCC) 4 to 7 cm in diameter. Material and Methods. The study included patients who underwent RN or NSS for RCC 4 to 7 cm in diameter between 1998 and 2009. The studied groups were compared with respect to the patients’ age, sex, physical status according to the American Society of Anesthesiologists Physical classification, histological type, stage, tumor size, grade, duration of the operation, and complications. Survival was established using the Kaplan-Meier method. The risk factors for survival were analyzed using a multivariate Cox regression model. Results. During the study, 351 patients underwent surgery: 317 patients (90.3%) underwent RN, and 34 (9.7%), NSS. The compared groups differed with respect to tumor size (P=0.001) and stage (P=0.006). The overall estimated 12-year survival was 53.7% after RN and 55.2% after NSS (log-rank test P=0.437). The 12-year cancer-specific survival in the RN and NSS groups was 69.6% and 80.6%, respectively (log-rank test P=0.198). Pathological stage and patients’ age were the major factors affecting both overall and cancer-specific survival. The type of surgery (NSS or RN) had no effect on survival. Conclusions. Our study showed that nephron-sparing surgery is a safe technique compared with radical nephrectomy that ensures good oncological control in the treatment of renal cell carcinoma measuring 4 to 7 cm and may be proposed as the treatment of choice for renal tumors not only up to 4 cm, but also 4 to 7 cm in size.

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