Short- and Long-Term Renal Function After Partial Nephrectomy: Comparison of Solitary and Multifocal Renal Masses.

Multifocal partial nephrectomy (MPN) is a critical management strategy for extirpation of multiple distinct renal masses; however, its short- and long-term impact on renal function remains poorly described. Herein we compared absolute glomerular filtration rate (GFR) and change from baseline at multiple time points after MPN and standard partial nephrectomy (SPN).

Perioperative and pathologic characteristics of 1307 partial nephrectomies performed from 2009 to 2020 were identified. 3:1 propensity score methods were used to match MPN and SPN cohorts based on preoperative characteristics known to impact renal function. Differences in GFR, perioperative outcomes, and overall and recurrence-free survival were assessed. Absolute and change from baseline GFR was compared at five timepoints for 36 months after partial nephrectomy.

After propensity score matching, 192 SPNs and 64 MPNs with a median GFR of 80.2 mL/min were compared. MPN was associated with a greater decline in GFR of between 11 to 18% for the first year compared to decline of 7 to 10% for SPN. This difference stabilized after 24 months. However, no differences in overall survival or recurrence free survival were observed. Median follow up time was 46.7 months.

Long-term renal function after MPN remains similar to SPN despite greater declines in the first year after excision of multifocal renal masses.

Urology practice. 2023 Dec 28 [Epub ahead of print]

Lachlan Shiver, Richard Sirard, Philippe E Spiess, Firaas Khan, Brandon J Manley, Chen Wang, Logan Zemp, Claude Bassil, Heather L Huelster

University of South Florida Morsani College of Medicine, Tampa, Florida., Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute; Tampa, Florida., Department of Onco-Nephrology, H. Lee Moffitt Cancer Center and Research Institute; Tampa, Florida.