Reported outcomes of partial nephrectomy (PN) for cT2 renal cell carcinoma (RCC) have been variable. We aimed to examine outcomes of PN, compared to radical nephrectomy (RN) for cT2 RCC.
Patients captured in the Canadian Kidney Cancer information system who underwent surgery for cT2 RCC between 2011 and 2023 were included. Clear cell, papillary, and chromophobe histologies were included. Multifocal tumors, and hereditary RCC syndromes were excluded. Groups were matched up to 1:4 based on tumor size, histology, grade and necrosis.
Of 1778 cT2 patients, 60 PN patients were matched to 224 RN patients. Positive surgical margins were 8.6% for PN vs. 2.8% for RN (P = 0.06). Postoperative complications were 18.3% for PN vs. 9.8% for RN (P = 0.07). Pathological upstaging to T3 was similar (21.7% PN vs. 22.3% RN, P = 0.73). There were no statistically significant recurrence or survival outcomes, however there were non-significant trends in local recurrence (HR 2.07, 95%CI 0.86-5.0), cancer specific survival (HR 0.65, 95%CI 0.19-2.16), overall survival (HR 0.66, 95%CI 0.28-1.57) for PN vs. RN. PN better preserved eGFR (-15.5 [IQR 27.7] vs. -24.4 [IQR 21.5], P = 0.026).
In a cohort of patients with non-metastatic cT2 RCC, PN has better preservation of renal function and may have a higher rate of perioperative complications and local recurrence. Acknowledging the presence of residual confounding, PN for T2 RCC is safe and provides acceptable oncological outcomes in well-selected patients.
Urologic oncology. 2026 Jun 09 [Epub ahead of print]
Rahul K Bansal, Raees Cassim, Ranjeeta Mallick, Frederic Pouliot, Miles P Mannas, Antonio Finelli, Simon Tanguay, Luke T Lavallée, Jasmir G Nayak, Ricardo A Rendon, Bimal Bhindi, Lori A Wood, Jean-Baptiste Lattouf, Lucas Dean, Naveen Basappa, Georg Bjarnason, Aly-Khan A Lalani, Rodney H Breau
Division of Urology, McMaster University, Hamilton, Ontario, Canada. Electronic address: ., Division of Urology, McMaster University, Hamilton, Ontario, Canada; Division of Urology, Department of Surgery, Washington University, St Louis, MO. Electronic address: ., Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada., Department of Urology, Centre Hospitalier Universitaire de Québec, Quebec, Quebec, Canada., Vancouver Prostate Centre, University of British Columbia, Vancouver, British Columbia, Canada., Division of Urology, University Health Network, Toronto, Quebec, Canada., Department of Urology, McGill University Health Centre, Montreal, Quebec, Canada., Section of Urology, University of Manitoba, Winnipeg, Manitoba, Canada., Department of Urology, Dalhousie University, Halifax, Nova Scotia, Canada., Department of Urology, Alberta Health Services, Calgary, Alberta, Canada., Dvision of Medical Oncology, Capital Health Queen Elizabeth II Hospital, Halifax, NS, Canada., Division of Urology, Centre Hospitalier de l'Université de Montréal, Montréal, Quebec, Canada., Division of Urology, Alberta Health Services, Edmonton, Alberta, Canada., Cross Cancer Institute, University of Alberta, Edmonton, Alberta, Canada., Division of Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada., Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada.