To examine the oncological outcome of patients in our centre who underwent partial or radical nephrectomy for T1 renal cancer (7 cm or smaller), and compare the likelihood of developing chronic kidney disease.
Historical cohort with internal comparison.
A tertiary hospital in Hong Kong.
We retrospectively reviewed a cohort of 86 patients with solitary T1 renal cancer and a normal contralateral kidney who underwent radical (38 patients) or partial (48 patients) nephrectomy between January 2005 and December 2010 in our centre.
Radical nephrectomy versus partial nephrectomy.
Overall and cancer-free survival, change in glomerular filtration rate, new onset of chronic kidney disease.
A total of 32 (84%) radical nephrectomy patients and 43 (90%) partial nephrectomy patients were alive by 31 December 2012. The mean follow-up was 43. 5 (standard deviation, 22. 4) months. There was no significant difference in overall survival (P=0. 29) or cancer-free survival (P=0. 29) between the two groups. Both groups enjoyed good oncological outcome with no recurrence in the partial nephrectomy group. Overall, 18 (21%) patients had pre-existing chronic kidney disease. The partial nephrectomy group had a significantly smaller median reduction in glomerular filtration rate (12. 6% vs 35. 4%; P
Compared with radical nephrectomy, partial nephrectomy can prevent chronic kidney disease and still achieve an excellent oncological outcome for T1 renal tumours, in particular T1a tumours and tumours with a low R. E. N. A. L. score.
Hong Kong medical journal = Xianggang yi xue za zhi / Hong Kong Academy of Medicine. 2015 Oct 23 [Epub ahead of print]
T Ct Lai, W K Ma, M K Yiu
Division of Urology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. , Division of Urology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong. , Division of Urology, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong.