MP70-09 GUIDELINE-ADAPTED USE OF NEPHRON-SPARING SURGERY FOR RENAL CELL CARCINOMA - A CONFIRMATORY TREND ANALYSIS OVER THE LAST DECADE IN TWO EUROPEAN REFERRAL CENTERS

Autor:	Manuela-Christine Kainz, Quoc-Dien Trinh, Georg C. Hutterer, Johanne Jesche, Richard Zigeumer, Karin Kampel-Kettner, Chun Felix, Thomas F. Chromecki, Christian Meyer, Marianne Schmid, Andreas Becker, Margit Fisch, Jens Hansen
Rok vydání:	2015
Předmět:	medicine.medical_specialty Kidney business.industry Urology medicine.medical_treatment Guideline medicine.disease Nephrectomy Surgery medicine.anatomical_structure Renal cell carcinoma Localized disease Epidemiology medicine business Kidney cancer Survival analysis
Zdroj:	Journal of Urology. 193
ISSN:	1527-3792 0022-5347
Popis:	INTRODUCTION AND OBJECTIVES: Increasing popularity and improved technical feasibility of partial nephrectomy (PN) has encouraged urologists to resect larger renal masses with nephron sparing surgery. The safety profile of PN in T2 renal lesions has yet to be defined. We used the Surveillance, Epidemiology, and End Results (SEER) registry to characterize national practice patterns for the surgical management of patients with renal masses larger than 7 cm in size confined to the kidney, and examined the effect of PN on cancer-specific survival in such patients. METHODS: Between 2001 and 2011, 10,259 patients with primary tumor size > 7 cm confined to the kidney (T2) were treated surgically for kidney cancer. The proportion of patients treated with PN was determined and trends were examined using joinpoint analysis, and quantified using the annual percentage change (APC). Multivariate survival models were developed to identify independent determinants of PN use and cancer specific survival following surgical treatment of kidney cancer. All possible interaction terms were tested for survival analysis to isolate patients who were at survival advantage when treated with PN. RESULTS: Overall 543 patients (5.29%) were treated with PN vs. 9,716 (94.71%) who underwent radical nephrectomy (TN). For T2 tumors, the use of PN increased progressively between 2001 (5.78%) and 2011 (7.47%) (APC þ11.1%, p 10 cm, localized disease, and papillary histology were all associated with improved cancer specific survival with PN (all p values < 0.05) CONCLUSIONS: There has been a trend towards increasing utilization of PN in the treatment of T2 renal masses over the past decade. Our analysis demonstrates that PN vs. TN for the management of patients with T2 renal masses has no contraindicated effect on cancer specific mortality.
Databáze:	OpenAIRE
Externí odkaz:	https://explore.openaire.eu/search/publication?articleId=doi_________::7420271ff5d1165f1a0c833ebb309fa7 https://doi.org/10.1016/j.juro.2015.02.2534 Zobrazit plný text záznamu