Radical Nephrectomy Is Not Superior To Nephron-Sparing Surgery In PT1b-pT2N0M0 Renal Tumors

Main Category: Urology / Nephrology
Also Included In: Cancer / Oncology;  Clinical Trials / Drug Trials
Article Date: 06 Apr 2008 - 0:00 PDT

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UroToday.com - Dr. Patard from Rennes, France presented on behalf of a large international group regarding partial nephrectomy (PN) and radical nephrectomy (RN) in the setting of organ confined tumor measuring more than 4 cm.

Out of a multi-institutional database including 2,406 PN procedures, 289 which were performed for pT1b-pT2N0M0 renal tumors were selected for comparison with a matched radical nephrectomy group. For that purpose, out of 1,507 renal tumors operated by radical nephrectomy (RN) and having identical TNM stage, 257 were selected after matching with the PN group for tumor size and Fuhrman grade.

Five hundred and forty six renal procedures were included in this retrospective study. During a mean follow-up of 54 months, only 36 (6.6%) patients died from cancer. The PN (n=289) and the RN groups (n=257), were comparable for age at diagnosis (59.3 vs. 61), tumor size (5.47vs. 5.5 cm), T stage (T1, 273(94.5%) vs. 241(93.8%)) and Fuhrman grade (G1-G2, 234(81%) vs. 204(79.4%)). When comparing cancer specific survival between the 2 groups, survival curves perfectly overlapped. Regarding predictive parameters, the authors found survival, T stage, Fuhrman grade and age at diagnosis significant in univariate analysis while T stage and age remained independent prognostic parameters in multivariate analysis. Surgical approach, in this selected low risk population had absolutely no impact on outcome either in uni- or in multi-variate analysis.

Presented by: J.J. Patard, MD, at the European Association of Urology - 23rd Annual EAU Congress - March 26 - 29, 2008 - Milan, Italy

Reported by UroToday.com Contributing Editor, Christopher P. Evans, MD

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