Functional outcomes of nephron-sparing surgery for renal cell carcinoma T1b–T2 stage

Autor: R.O. Danylets, M.V. Vikarchuk, L.V. Pereta, O.O. Banas, V.M. Grygorenko, A.P. Nesterchuk, A.P. Onyshchuk
Rok vydání: 2018
Předmět:
Zdroj: Urology. 22
ISSN: 2307-5279
DOI: 10.26641/2307-5279.22.3.2018.143272
Popis: Aim. To compare the functional outcomes of radical nephrectomy (NE) and partial nephrectomy (PN) in patients with T1b-T2 renal cell carcinoma (RCC). Materials and methods. A retrospective assessment of the functional results of 167 patients with RCC clinical stage T1b-T2N0M0, which were operated in period from 2012 to 2015 were done. PN was performed in 79 patients (47.0%), NE – 88 (53.0%). Functional results were evaluated by determining the rate of glomerular filtration (GFR) using the Cockroft–Holt’s formula. Results. In the PN and NE group, the GFR before surgery was 99.3 and 93.4 ml/min/1.73 m2 (p=0.284), after 7 days 86.3 and 76.5 ml/min/1.73 m2 (p=0.021), after 1 year after surgery 82.1 and 70.1 ml/min/1.73 m2 (p=0.0003), respectively. 1 After 1 year after surgery GFR decreased in the group of PN by 13.0%, in the group of NE – by 21.4% (p = 0.003). Also, after NE, the number of patients with III–IV stage of chronic kidney disease (CKD) increased by 21.2% (p=0.0023), after PN – did not change. Conclusions. Retrospective evaluation of functional results of surgical treatment of T1b-T2 RCC in the early postoperative period and 1 year after surgery demonstrated that PN provides better preservation of functional renal parenchyma and renal function, as well as a decrease of the number of patients with clinically significant CKD, compared to NE.
Databáze: OpenAIRE