A comparison of overall survival and perioperative outcomes between partial and radical nephrectomy for cT1b and cT2 renal cell carcinoma—Analysis of a national cancer registry

Partial nephrectomy (PN) is the standard management of cT1a renal cell carcinoma (RCC), and there is a basis for expanding its indications to larger tumors (cT1b and cT2). We analyzed a large population-based cancer registry to compare the overall survival (OS) and perioperative outcomes in patients...

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Bibliographic Details
Published in:Urologic oncology 2018-03, Vol.36 (3), p.90.e9-90.e14
Main Authors: Venkatramani, Vivek, Koru-Sengul, Tulay, Miao, Feng, Nahar, Bruno, Prakash, Nachiketh Soodana, Swain, Sanjaya, Punnen, Sanoj, Ritch, Chad, Gonzalgo, Mark, Parekh, Dipen
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell - mortality
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - surgery
cT1b and cT2
Female
Follow-Up Studies
Humans
Kidney - pathology
Kidney - surgery
Kidney Neoplasms - mortality
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Male
Middle Aged
Neoplasm Staging
Nephrectomy - adverse effects
Nephrectomy - methods
Overall survival
Partial nephrectomy
Patient Readmission - statistics & numerical data
Perioperative outcomes
Perioperative Period
Postoperative Complications - epidemiology
Postoperative Complications - etiology
Radical nephrectomy
Registries - statistics & numerical data
Retrospective Studies
Survival Analysis
Treatment Outcome
United States - epidemiology
Young Adult
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Summary:Partial nephrectomy (PN) is the standard management of cT1a renal cell carcinoma (RCC), and there is a basis for expanding its indications to larger tumors (cT1b and cT2). We analyzed a large population-based cancer registry to compare the overall survival (OS) and perioperative outcomes in patients with cT1b and cT2 RCC undergoing PN with those undergoing radical nephrectomy (RN). Patients with cT1bN0M0 and cT2N0M0 RCC were identified from the National Cancer Database (2004–2013). Patients were classified by the surgery performed and 1:1 propensity matched based on the likelihood of receiving PN. They were then compared for OS, 30-day readmission rates and 30- and 90-day mortality. A total of 6,072 patients underwent PN. PN was associated with better OS in cT1b tumors on multivariate analyses (OR = 0.8; 95% CI: 0.72–0.89; P
ISSN:1078-1439
1873-2496
DOI:10.1016/j.urolonc.2017.11.008