A comparison of renal function outcomes after nephron-sparing surgery and radical nephrectomy for nonsyndromic unilateral wilms tumor

Nicholas G. Cost, Krystyna Sawicz-Birkowska, Abdol Mohammad Kajbafzadeh, Ali Tourchi, Gian Battista Parigi, Gabriela Guillén, W. Robert Defoor, Wojciech Apoznanski

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objective To better understand the impact of nephron-sparing surgery (NSS) on renal function in patients with nonsyndromic unilateral Wilms tumor (uWT), a group of such patients treated with NSS were compared with a stage-matched cohort managed with radical nephrectomy (RN). The recommended management of nonsyndromic uWT is RN. However, NSS may decrease the risk of long-term renal disease and associated comorbidities. Materials and Methods An international, multi-institutional review was conducted of nonsyndromic uWT cases managed with NSS and compared with a stage-matched RN cohort. Data were collected on demographics, oncologic characteristics and outcomes, serum creatinine, and estimated glomerular filtration rate (eGFR) calculated via Schwartz formula. Results Fifteen patients who underwent NSS (6 females and 9 males) met study criteria and were diagnosed at a median age of 2.5 years (range, 0.2-8.2 years) and followed for a median of 8.4 years (range, 0.5-31.8 years). The stage-matched RN cohort consisted of 15 patients (8 females and 7 males) diagnosed at a median age of 3.7 years (0.3-7.4) and followed for a median of 2.1 years (0.6-10.5 years). The median preoperative eGFR was 91.7 (39.4-237.7) and 149.9 (93.8-215.9) for NSS and RN, respectively, P =.026. The median eGFR at last follow-up was 135.3 (57.5-185.8) and 131.0 (98.6-161.2) for NSS and RN, respectively, P =.95. The median change in eGFR during the study period was a gain of 28.6 (-51.9 to 83.0) for the NSS cohort vs a loss of 19.1 (-54.7 to 25.2) for the RN cohort, P =.007. Conclusion In a highly selected patient population with nonsyndromic uWT, NSS provides excellent renal function preservation when compared with RN. These data require validation via prospective investigation on a larger scale.

Original languageEnglish
Pages (from-to)1388-1393
Number of pages6
JournalUrology
Volume83
Issue number6
DOIs
Publication statusPublished - 2014

Fingerprint

Wilms Tumor
Nephrons
Nephrectomy
Kidney
Glomerular Filtration Rate
Comorbidity
Creatinine
Demography

ASJC Scopus subject areas

  • Urology

Cite this

A comparison of renal function outcomes after nephron-sparing surgery and radical nephrectomy for nonsyndromic unilateral wilms tumor. / Cost, Nicholas G.; Sawicz-Birkowska, Krystyna; Kajbafzadeh, Abdol Mohammad; Tourchi, Ali; Parigi, Gian Battista; Guillén, Gabriela; Defoor, W. Robert; Apoznanski, Wojciech.

In: Urology, Vol. 83, No. 6, 2014, p. 1388-1393.

Research output: Contribution to journalArticle

Cost, NG, Sawicz-Birkowska, K, Kajbafzadeh, AM, Tourchi, A, Parigi, GB, Guillén, G, Defoor, WR & Apoznanski, W 2014, 'A comparison of renal function outcomes after nephron-sparing surgery and radical nephrectomy for nonsyndromic unilateral wilms tumor', Urology, vol. 83, no. 6, pp. 1388-1393. https://doi.org/10.1016/j.urology.2014.01.051
Cost, Nicholas G. ; Sawicz-Birkowska, Krystyna ; Kajbafzadeh, Abdol Mohammad ; Tourchi, Ali ; Parigi, Gian Battista ; Guillén, Gabriela ; Defoor, W. Robert ; Apoznanski, Wojciech. / A comparison of renal function outcomes after nephron-sparing surgery and radical nephrectomy for nonsyndromic unilateral wilms tumor. In: Urology. 2014 ; Vol. 83, No. 6. pp. 1388-1393.
@article{7c6e7f127aeb4c43aff0d724b8058638,
title = "A comparison of renal function outcomes after nephron-sparing surgery and radical nephrectomy for nonsyndromic unilateral wilms tumor",
abstract = "Objective To better understand the impact of nephron-sparing surgery (NSS) on renal function in patients with nonsyndromic unilateral Wilms tumor (uWT), a group of such patients treated with NSS were compared with a stage-matched cohort managed with radical nephrectomy (RN). The recommended management of nonsyndromic uWT is RN. However, NSS may decrease the risk of long-term renal disease and associated comorbidities. Materials and Methods An international, multi-institutional review was conducted of nonsyndromic uWT cases managed with NSS and compared with a stage-matched RN cohort. Data were collected on demographics, oncologic characteristics and outcomes, serum creatinine, and estimated glomerular filtration rate (eGFR) calculated via Schwartz formula. Results Fifteen patients who underwent NSS (6 females and 9 males) met study criteria and were diagnosed at a median age of 2.5 years (range, 0.2-8.2 years) and followed for a median of 8.4 years (range, 0.5-31.8 years). The stage-matched RN cohort consisted of 15 patients (8 females and 7 males) diagnosed at a median age of 3.7 years (0.3-7.4) and followed for a median of 2.1 years (0.6-10.5 years). The median preoperative eGFR was 91.7 (39.4-237.7) and 149.9 (93.8-215.9) for NSS and RN, respectively, P =.026. The median eGFR at last follow-up was 135.3 (57.5-185.8) and 131.0 (98.6-161.2) for NSS and RN, respectively, P =.95. The median change in eGFR during the study period was a gain of 28.6 (-51.9 to 83.0) for the NSS cohort vs a loss of 19.1 (-54.7 to 25.2) for the RN cohort, P =.007. Conclusion In a highly selected patient population with nonsyndromic uWT, NSS provides excellent renal function preservation when compared with RN. These data require validation via prospective investigation on a larger scale.",
author = "Cost, {Nicholas G.} and Krystyna Sawicz-Birkowska and Kajbafzadeh, {Abdol Mohammad} and Ali Tourchi and Parigi, {Gian Battista} and Gabriela Guill{\'e}n and Defoor, {W. Robert} and Wojciech Apoznanski",
year = "2014",
doi = "10.1016/j.urology.2014.01.051",
language = "English",
volume = "83",
pages = "1388--1393",
journal = "Urology",
issn = "0090-4295",
publisher = "Elsevier Inc.",
number = "6",

}

TY - JOUR

T1 - A comparison of renal function outcomes after nephron-sparing surgery and radical nephrectomy for nonsyndromic unilateral wilms tumor

AU - Cost, Nicholas G.

AU - Sawicz-Birkowska, Krystyna

AU - Kajbafzadeh, Abdol Mohammad

AU - Tourchi, Ali

AU - Parigi, Gian Battista

AU - Guillén, Gabriela

AU - Defoor, W. Robert

AU - Apoznanski, Wojciech

PY - 2014

Y1 - 2014

N2 - Objective To better understand the impact of nephron-sparing surgery (NSS) on renal function in patients with nonsyndromic unilateral Wilms tumor (uWT), a group of such patients treated with NSS were compared with a stage-matched cohort managed with radical nephrectomy (RN). The recommended management of nonsyndromic uWT is RN. However, NSS may decrease the risk of long-term renal disease and associated comorbidities. Materials and Methods An international, multi-institutional review was conducted of nonsyndromic uWT cases managed with NSS and compared with a stage-matched RN cohort. Data were collected on demographics, oncologic characteristics and outcomes, serum creatinine, and estimated glomerular filtration rate (eGFR) calculated via Schwartz formula. Results Fifteen patients who underwent NSS (6 females and 9 males) met study criteria and were diagnosed at a median age of 2.5 years (range, 0.2-8.2 years) and followed for a median of 8.4 years (range, 0.5-31.8 years). The stage-matched RN cohort consisted of 15 patients (8 females and 7 males) diagnosed at a median age of 3.7 years (0.3-7.4) and followed for a median of 2.1 years (0.6-10.5 years). The median preoperative eGFR was 91.7 (39.4-237.7) and 149.9 (93.8-215.9) for NSS and RN, respectively, P =.026. The median eGFR at last follow-up was 135.3 (57.5-185.8) and 131.0 (98.6-161.2) for NSS and RN, respectively, P =.95. The median change in eGFR during the study period was a gain of 28.6 (-51.9 to 83.0) for the NSS cohort vs a loss of 19.1 (-54.7 to 25.2) for the RN cohort, P =.007. Conclusion In a highly selected patient population with nonsyndromic uWT, NSS provides excellent renal function preservation when compared with RN. These data require validation via prospective investigation on a larger scale.

AB - Objective To better understand the impact of nephron-sparing surgery (NSS) on renal function in patients with nonsyndromic unilateral Wilms tumor (uWT), a group of such patients treated with NSS were compared with a stage-matched cohort managed with radical nephrectomy (RN). The recommended management of nonsyndromic uWT is RN. However, NSS may decrease the risk of long-term renal disease and associated comorbidities. Materials and Methods An international, multi-institutional review was conducted of nonsyndromic uWT cases managed with NSS and compared with a stage-matched RN cohort. Data were collected on demographics, oncologic characteristics and outcomes, serum creatinine, and estimated glomerular filtration rate (eGFR) calculated via Schwartz formula. Results Fifteen patients who underwent NSS (6 females and 9 males) met study criteria and were diagnosed at a median age of 2.5 years (range, 0.2-8.2 years) and followed for a median of 8.4 years (range, 0.5-31.8 years). The stage-matched RN cohort consisted of 15 patients (8 females and 7 males) diagnosed at a median age of 3.7 years (0.3-7.4) and followed for a median of 2.1 years (0.6-10.5 years). The median preoperative eGFR was 91.7 (39.4-237.7) and 149.9 (93.8-215.9) for NSS and RN, respectively, P =.026. The median eGFR at last follow-up was 135.3 (57.5-185.8) and 131.0 (98.6-161.2) for NSS and RN, respectively, P =.95. The median change in eGFR during the study period was a gain of 28.6 (-51.9 to 83.0) for the NSS cohort vs a loss of 19.1 (-54.7 to 25.2) for the RN cohort, P =.007. Conclusion In a highly selected patient population with nonsyndromic uWT, NSS provides excellent renal function preservation when compared with RN. These data require validation via prospective investigation on a larger scale.

UR - http://www.scopus.com/inward/record.url?scp=84901587948&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84901587948&partnerID=8YFLogxK

U2 - 10.1016/j.urology.2014.01.051

DO - 10.1016/j.urology.2014.01.051

M3 - Article

C2 - 24768019

AN - SCOPUS:84901587948

VL - 83

SP - 1388

EP - 1393

JO - Urology

JF - Urology

SN - 0090-4295

IS - 6

ER -