A population-based comparison of cancer-control rates between radical and partial nephrectomy for T1A renal cell carcinoma

Maxime Crépel, Claudio Jeldres, Maxine Sun, Giovanni Lughezzani, Hendrik Isbarn, Ahmed Alasker, Umberto Capitanio, Shahrokh F. Shariat, Philippe Arjane, Hugues Widmer, Markus Graefen, Francesco Montorsi, Paul Perrotte, Pierre I. Karakiewicz

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Abstract

OBJECTIVES: To complement existing data with population-based cancer control outcomes that account for the effect of other-cause mortality (OCM). Cancer control rates are virtually equivalent between partial (PN) and radical nephrectomy (RN) for patients with T1aN0M0 renal cell carcinoma (RCC). To date, only 6 studies from centers of excellence examined cancer control rates after PN vs RN for T1aN0M0 RCC. OCM was unaccounted for in those studies, which may introduce a bias. We relied on the surveillance, epidemiology, and end results (SEER) database and assessed cancer-specific mortality (CSM) after either PN or RN for T1aN0M0 RCC, in competing-risks models. METHODS: Between 1988 and 2004, the SEER-9 database identified 1622 PN (22.3%) and 5658 RN (77.7%) T1aN0M0 RCC. Competing-risks regression models, controlling for OCM and matched for age, year of surgery, tumor size, and Fuhrman grade, addressed the effect of nephrectomy type (PN vs RN) on CSM. RESULTS: At 5 years, in a PN and RN matched-population controlling for OCM, CSM after PN and RN was respectively 1.8% vs 2.5% (P = .5). The CSM rates in this cohort for patients aged <70 years were respectively 1.0% and 3.4% (P = .7). CONCLUSIONS: This competing-risks population-based analysis confirmed the CSM equivalence between PN and RN for T1aN0M0 RCC and showed virtually perfect CSM-free rates (97.5% or better) even in older patients.

Original languageEnglish
Pages (from-to)883-888
Number of pages6
JournalUrology
Volume76
Issue number4
DOIs
Publication statusPublished - Oct 2010

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ASJC Scopus subject areas

  • Urology

Cite this

Crépel, M., Jeldres, C., Sun, M., Lughezzani, G., Isbarn, H., Alasker, A., Capitanio, U., Shariat, S. F., Arjane, P., Widmer, H., Graefen, M., Montorsi, F., Perrotte, P., & Karakiewicz, P. I. (2010). A population-based comparison of cancer-control rates between radical and partial nephrectomy for T1A renal cell carcinoma. Urology, 76(4), 883-888. https://doi.org/10.1016/j.urology.2009.08.028