Nephron sparing surgery for renal cell carcinoma in a solitary kidney |
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Authors: | Sascha Pahernik Frederik Roos Chistoph Wiesner Joachim W Thüroff |
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Institution: | Department of Urology and Pediatric Urology, Johannes Gutenberg University, Langenbeckstrasse 1, 55101 Mainz, Germany. |
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Abstract: | To determine functional and oncological outcomes of nephron sparing surgery (NSS) for renal cell carcinoma (RCC). We identified
from our kidney database 103 consecutive patients undergoing NSS for solid renal tumors in a solitary kidney. After excluding
17 patients (16.5%) undergoing NSS with palliative intent in presence of preoperatively diagnosed metastatic disease (n = 15) or positive lymph nodes (n = 2) and 6 patients (5.8%) who turned out to have benign tumors, the remaining 80 patients with RCC were analyzed. Mean follow-up
is 8.0 years (range: 0.1–25.8). Mean tumor size was 4.2 cm (range 1.2–11 cm). Chronic renal failure requiring hemodialysis
developed after NSS in nine patients (11.2%). In the remainder, serum creatinine was 1.72 mg/dl (range: 0.45–4.6 mg/dl) at
latest follow-up. The cancer specific survival rates at 1, 5 and 10 years were 97.2, 89.6 and 76%, respectively. The estimated
local recurrence free survival rates at 1, 5 and 10 years were 97.8, 89.4 and 79.9%, respectively. Univariate analysis of
correlation between clinical and pathologic features with death from RCC showed significant associations for grading and tumor
size. The long-term data of our series support the concept of organ-sparing surgery for RCC in a solitary kidney since it
provides excellent local tumor control and cancer specific survival and preserves renal function renal function so that 89%
of patients remained free of dialysis in the long-run. |
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Keywords: | Nephron sparing surgery Renal cell carcinoma Solitary kidney |
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