Comparison of outcomes in elective partial vs radical nephrectomy for clear cell renal cell carcinoma of 4-7 cm
| Autor: | Lee R. Schachter, Atreya Dash, Andrew J. Vickers, Ariadne M. Bach, Paul Russo, Mark E. Snyder |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment Nephrectomy Disease-Free Survival Renal cell carcinoma medicine Humans Carcinoma Renal Cell Proportional hazards model business.industry Hazard ratio Middle Aged medicine.disease Kidney Neoplasms Surgery Clear cell renal cell carcinoma Treatment Outcome Clear cell carcinoma Multivariate Analysis Female business Kidney cancer Kidney disease |
| Zdroj: | BJU international. 97(5) |
| ISSN: | 1464-4096 |
| Popis: | OBJECTIVE To compare the outcomes of patients who had a elective partial nephrectomy (PN) or radical nephrectomy (RN) for clear cell renal cell carcinoma (RCC) of 4–7 cm. PATIENTS AND METHODS From March 1998 to July 2004, 45 and 151 patients underwent PN and RN, respectively, for clear cell RCC. A multivariate Cox model was constructed for disease-free survival with adjustment for markers of disease severity, and a propensity-score approach used as a confirmatory analysis. RESULTS In the PN and RN cohorts the treatment failed in one and 20 patients, respectively; the median follow-up was 21 months. The hazard ratio (95% confidence interval) for PN after adjusting for disease severity was 0.36 (0.05–2.82; P = 0.3). Using planned PN as a predictor (intent-to-treat analysis) the hazard ratio was 1.06 (0.32–3.53; P = 0.9). In the propensity-score model, planned PN was associated with a hazard ratio of 1.75 (0.50–6.14; P = 0.4). The serum creatinine level 3 months after surgery was significantly lower in patients who had PN, with a difference between the means of 0.36 (0.23–0.48; P |
| Databáze: | OpenAIRE |
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