Résultats de la néphrectomie partielle pour les tumeurs de plus de 7cm : comparaison avec la néphrectomie élargie
| Autor: | Anthony Giwerc, Mathieu Roumiguié, M. Soulié, Nicolas Doumerc, A Aublé, F.X. Nouhaud, Thibaut Benoit, C. Pfister, A. Chebbi, Jean-Baptiste Beauval |
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| Přispěvatelé: | Laboratoire Interuniversitaire des Systèmes Atmosphériques (LISA (UMR_7583)), Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Centre National de la Recherche Scientifique (CNRS), Département d'urologie, CHU Toulouse [Toulouse]-Hôpital de Rangueil, CHU Toulouse [Toulouse], Service d'Urologie - Transplantation Rénale - Andrologie, CHU Rouen, Normandie Université (NU), Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12)-Institut national des sciences de l'Univers (INSU - CNRS)-Université Paris Diderot - Paris 7 (UPD7)-Centre National de la Recherche Scientifique (CNRS) |
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
business.industry [SDV]Life Sciences [q-bio] Urology medicine.medical_treatment 030232 urology & nephrology Renal function Retrospective cohort study Perioperative Renal tumor Nephrectomy 3. Good health 03 medical and health sciences 0302 clinical medicine 030220 oncology & carcinogenesis Medicine [SDV.SPEE]Life Sciences [q-bio]/Santé publique et épidémiologie Young adult business Complication Survival rate ComputingMilieux_MISCELLANEOUS |
| Zdroj: | Progrès en Urologie Progrès en Urologie, Elsevier Masson, 2017, 27 (2), pp.80-86. ⟨10.1016/j.purol.2016.12.002⟩ |
| ISSN: | 1166-7087 2405-5131 |
| DOI: | 10.1016/j.purol.2016.12.002 |
| Popis: | Introduction The usefulness of partial nephrectomy (PN) has been demonstrated for the treatment of renal tumor 7cm. Materials and methods A retrospective two-center study was performed, including 170 patients treated. Thirty-two patients underwent PN and 138 radical nephrectomy (RN) for renal cT2 tumors between 2004 and 2014. The biological and clinical characteristics including perioperative morbidity as well as the survival rate were compared between these 2 groups. Results The median age was 59.5 years and the median follow-up was 47 months. More cT2b tumors were treated through RN (34.1% vs. 12.5%, P=0.01). The postoperative decrease in creatinine clearance was higher for the RN group (-24.3mL/min vs. -16.8; P=0.04). This difference was no longer significant at last follow-up. Perioperative complications were more frequent in the PN group (50.0% vs. 18.1%; P=0.008), and more severe (Clavien≥3 18.7% vs. 5.1%, P=0.01). No difference was found regarding the overall survival. Surgical margins were more frequent in the PN group (9.1% vs. 0.85%; P=0.01). Conclusion Our results suggested the feasibility of PN for renal tumors>7cm, involving however a higher perioperative complication risk. Cautious patient selection appeared to be required for the indication of PN for large tumors. Level of evidence 4. |
| Databáze: | OpenAIRE |
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