The value of nephron-sparing surgery for the treatment of renal cell carcinoma 4 to 7 cm in size.
نویسندگان
چکیده
Nephron-sparing surgery (NSS) is a treatment of choice for renal cell carcinoma (RCC) less than 4 cm. in size. However its efficacy in the treatment of RCC from 4cm to 7 cm is not well defined and is still controversial. We retrospectively reviewed the records of 57 patients who underwent NSS at our institution for RCC of 4-7 cm in size, from 1994 to 2011. NSS was done by means of enucleoresection and/or eucleation. The mean follow-up was 70.1 months (range: 10-157 months). Mean patient age was 53.1 years. NSS was performed for absolute indications in 5 (8.8%), for relative indications in 11 (19.3%) and for elective indications in 41 (71.9%) patients. The tumour size was significantly higher in the patients with absolute indication as compared with the patients operated for relative and elective indications (p<0.04). The difference between the later two groups was not significant. The tumour recurred in 6 (10.5%) patients. Of them, local recurrence was detected in 2 (3.5%) and systemic recurrence in 4 (7%) patients. At the end of follow-up overall survival was 85.8%, disease-free survival was 82.4%. Both, overall and disease-free survivals were significantly better in the patients operated for relative and elective indications as compared to absolute indication (p<0.014 and p<0.023, respectively). NSS is a feasible procedure for RCCs 4 cm to7 cm in size. Local cancer control can be achieved in most patients. Oncological outcome was negatively related with the tumor size. Long-term prospective studies are required to prove the similar oncological efficacy of NSS and radical nephrectomy (RN) in RCC of 4 cm to7 cm in size.
منابع مشابه
Elective nephron sparing surgery for renal cell carcinoma larger than 4 cm.
PURPOSE Elective nephron sparing surgery is established as an alternative to radical nephrectomy for renal cell carcinoma if tumors are small (4 cm or less, stage T1a). We compared outcomes in patients with renal cell carcinoma 4 cm or less (small) vs more than 4 cm (large) who were treated with nephron sparing surgery. MATERIALS AND METHODS Between 1979 and 2006, 618 patients underwent elect...
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عنوان ژورنال:
- Georgian medical news
دوره 212 شماره
صفحات -
تاریخ انتشار 2012