Radical versus partial nephrectomy

Autor: Paul Perrotte, Laurent Zini, Fred Saad, Jean Jacques Patard, Shahrokh F. Shariat, Umberto Capitanio, Elie Antebi, Francesco Montorsi, Claudio Jeldres, Pierre I. Karakiewicz
Přispěvatelé: Cancer Prognostics and Health Outcome Unit, Université de Montréal (UdeM), Service d'urologie, Hôpital Huriez-Centre Hospitalier Régional Universitaire [Lille] (CHRU Lille), Cancer Prognostics and Health Outcomes Unit, Department of urology, Università Vita-Salute San Raffaele, Institut de Génétique et Développement de Rennes (IGDR), Centre National de la Recherche Scientifique (CNRS)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES), Service d'urologie [Rennes] = Urology [Rennes], Hôpital Pontchaillou-CHU Pontchaillou [Rennes], Funded by: University of Montreal Health Center Urology Associates/Fonds de la Recherche en Santé du Québec/ University of Montreal Department of Surgery/University of Montreal Health Center (CHUM) Foundation/ Association Française de Recherche sur le Cancer/Fondation de France-Fédération Nationale des Centres de Lutte Contre le Cancer/Association Française d'Urologie/Ministère Français des Affaires Etrangères et Européennes (Bourse Lavoisier), Zini, Laurent, Perrotte, Paul, Capitanio, Umberto, Jeldres, Claudio, Shariat Shahrokh, F., Antebi, Elie, Saad, Fred, Patard Jean, Jacque, Montorsi, Francesco, Karakiewicz Pierre, I., Université de Rennes (UR)-Centre National de la Recherche Scientifique (CNRS), De Villemeur, Hervé
Rok vydání: 2009
Předmět:
Male
Cancer Research
medicine.medical_specialty
[SDV.MHEP.CHI] Life Sciences [q-bio]/Human health and pathology/Surgery
medicine.medical_treatment
030232 urology & nephrology
Urology
[SDV.CAN]Life Sciences [q-bio]/Cancer
[SDV.MHEP.CHI]Life Sciences [q-bio]/Human health and pathology/Surgery
Nephrectomy
[SDV.MHEP.UN]Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
[SDV.CAN] Life Sciences [q-bio]/Cancer
Renal cell carcinoma
MESH: Postoperative Complications
medicine
Humans
Carcinoma
Renal Cell
Survival analysis
MESH: Humans
MESH: Middle Aged
business.industry
Proportional hazards model
Mortality rate
MESH: Carcinoma
Renal Cell
Middle Aged
medicine.disease
Survival Analysis
[SDV.MHEP.UN] Life Sciences [q-bio]/Human health and pathology/Urology and Nephrology
Kidney Neoplasms
MESH: Male
3. Good health
Surgery
MESH: Nephrectomy
Oncology
MESH: Survival Analysis
030220 oncology & carcinogenesis
Cohort
MESH: SEER Program
Female
MESH: Kidney Neoplasms
business
MESH: Female
Kidney cancer
SEER Program
Kidney disease
Zdroj: Cancer / Cancer (Phila)
Cancer / Cancer (Phila), 2009, 115 (7), pp.1465-71. ⟨10.1002/cncr.24035⟩
ISSN: 1097-0142
0008-543X
DOI: 10.1002/cncr.24035
Popis: BACKGROUND: Relative to radical nephrectomy (RN), partial nephrectomy (PN) performed for renal cell carcinoma (RCC) may protect from non-cancer-related deaths. The authors tested this hypothesis in a cohort of PN and RN patients. METHODS: The Surveillance, Epidemiology, and End Results-9 database allowed identification of 2198 PN (22.4%) and 7611 RN (77.6%) patients treated for T1aN0M0 RCC between 1988 and 2004. Analyses matched for age, year of surgery, tumor size, and Fuhrman grade addressed the effect of nephrectomy type (RN vs PN) on overall mortality (Cox regression models) and on non-cancer-related mortality (competing-risks regression models). RESULTS: Relative to PN, RN was associated with 1.23-fold (P = .001) increased overall mortality rate, which translated into a 4.9% and 3.1% absolute increase in mortality at 5 and 10 years after surgery, respectively. Similarly, non-cancer-related death rate was significantly higher after RN in competing-risks regression models (P < .001), which translated into a 4.6% and 4.5% absolute increase in non-cancer-related mortality at 5 and 10 years after surgery, respectively. CONCLUSIONS: Relative to PN, RN predisposes to an increase in overall mortality and non-cancer-related death rate in patients with T1a RCC. In consequence, PN should be attempted whenever technically feasible. Selective referrals should be considered if PN expertise is unavailable Cancer 2009. © 2009 American Cancer Society.
Databáze: OpenAIRE
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