Partial Versus Radical Nephrectomy in Patients With Adverse Clinical or Pathologic Characteristics

Claudio Jeldres, Jean Jacques Patard, Umberto Capitanio, Paul Perrotte, Nazareno Suardi, Maxime Crepel, Vincenzo Ficarra, Luca Cindolo, Alexandre de La Taille, Jacques Tostain, Christian Pfister, Baptiste Albouy, Marc Colombel, Arnaud Méjean, Hervé Lang, Didier Jacqmin, Jean Christophe Bernhard, Jean Marie Ferrière, Karim Bensalah, Pierre I. Karakiewicz

Research output: Contribution to journalArticle

Abstract

Objectives: To assess cancer-specific survival of partial nephrectomy (PN) patients with ≥ 7-cm lesions or unfavorable pathology (stage T3a or Fuhrman grades III-IV). Material and Methods: At 13 participation centers, 4072 partial or radical nephrectomies (RN) were performed for RCC between 1984 and 2001. Of all procedures, 925 (22.7%) were for tumors > 7 cm, 973 (23.9%) had Fuhrman grades III or IV, and 861 (21.1%) had stage pT3a. None had nodal or distant metastases. Matched (age, gender, tumor size, T stage, histologic subtype, and Fuhrman grade [FG]) survival analyses addressed the effect of nephrectomy type (partial vs radical) on cancer-specific mortality. Results: Partial nephrectomy for tumors > 7 cm was associated with higher mortality than RN (HR = 5.3; P = .025). No significant cancer-specific survival differences were recorded after PN for FG III-IV (HR = 0.7, P = .5) or for pT3a lesions (HR = 2.5, P = .9). Conclusions: Partial nephrectomy may undermine cancer control in patients with tumors > 7 cm. Conversely, after PN, the same cancer control rates as after RN may be expected in patients with Fuhrman grades III-IV or with pT3a histology.

Original languageEnglish
Pages (from-to)1300-1305
Number of pages6
JournalUrology
Volume73
Issue number6
DOIs
Publication statusPublished - Jun 2009

ASJC Scopus subject areas

  • Urology

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    Jeldres, C., Patard, J. J., Capitanio, U., Perrotte, P., Suardi, N., Crepel, M., Ficarra, V., Cindolo, L., Taille, A. D. L., Tostain, J., Pfister, C., Albouy, B., Colombel, M., Méjean, A., Lang, H., Jacqmin, D., Bernhard, J. C., Ferrière, J. M., Bensalah, K., & Karakiewicz, P. I. (2009). Partial Versus Radical Nephrectomy in Patients With Adverse Clinical or Pathologic Characteristics. Urology, 73(6), 1300-1305. https://doi.org/10.1016/j.urology.2008.08.492