In:
BJU International, Wiley, Vol. 117, No. 6B ( 2016-06)
Abstract:
To assess differences in overall survival ( OS ) between patients receiving partial nephrectomy ( PN ) and radical nephrectomy ( RN ) for stage 1 renal cell carcinoma ( RCC ) according to age distribution, as the survival advantage of PN vs RN has been unclear owing to conflicting data. Patients and Methods We studied 952 patients with stage 1 RCC who underwent either PN or RN . Patients were divided into three groups according to age: Group 1 (≤54 years), Group 2 (55–64 years), and Group 3 (≥65 years). Patient variables including age, body mass index, sex, presence of hypertension ( HT ) and/or diabetes mellitus ( DM ), performance status, tumour size, pathological diagnosis, nuclear grade, and preoperative estimated glomerular filtration rate ( eGFR ), were adjusted using 1:1 propensity score matching between PN and RN . Results Group 1 included 66 matched patients; Group 2, 72; and Group 3, 70. Group 1 tended to have higher preoperative eGFR values and lower rates of HT and DM compared with Groups 2 and 3. Postoperative eGFR dropped by 11–13% in PN patients and by 34–36% in RN patients. In Group 3, PN patients had longer OS than RN patients (5‐year OS : PN 96%, RN 81%, P = 0.043); however, there was no significant difference in Group 1 (5‐year OS : PN 100%, RN 93%, P = 0.302) or Group 2 (5‐year OS : PN 94%, RN 87%, P = 0.358). Conclusions Only the oldest group of patients showed significantly better OS for PN compared with RN ; however, we still recommend PN in young patients.
Type of Medium:
Online Resource
ISSN:
1464-4096
,
1464-410X
DOI:
10.1111/bju.2016.117.issue-6B
Language:
English
Publisher:
Wiley
Publication Date:
2016
detail.hit.zdb_id:
2019983-1
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