Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: Results of a nonrandomized, retrospective, comparative study

Andrea Minervini, Vincenzo Ficarra, Francesco Rocco, Alessandro Antonelli, Roberto Bertini, Giorgio Carmignani, Sergio Cosciani Cunico, Dario Fontana, Nicola Longo, Giuseppe Martorana, Vincenzo Mirone, Giuseppe Morgia, Giacomo Novara, Marco Roscigno, Riccardo Schiavina, Sergio Serni, Claudio Simeone, Alchiede Simonato, Salvatore Siracusano, Alessandro VolpeFiliberto Zattoni, Alessandro Zucchi, Marco Carini, O. De Cobelli, S. Corti, M. Castelli, S. Cimino, V. Favilla, M. Billia, C. Terrone, C. Imbimbo, L. Masieri, F. Oneto, V. Varca, C. Valotto, E. Costantini, M. Porena, S. Ciciliato, N. Lampropoulou, P. Gontero, A. Tizzani, W. Artibani, M. Brunelli, G. Martignoni, R. Bertini, F. Montorsi, G. Petralia, M. Roscigno, E. Strada

Research output: Contribution to journalArticle

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Abstract

Purpose: The excision of the renal tumor with a substantial margin of healthy parenchyma is considered the gold standard technique for partial nephrectomy. However, simple enucleation showed excellent results in some retrospective series. We compared the oncologic outcomes after standard partial nephrectomy and simple enucleation. Materials and Methods: We retrospectively analyzed 982 patients who underwent standard partial nephrectomy and 537 who had simple enucleation for localized renal cell carcinoma at 16 academic centers between 1997 and 2007. Local recurrence, cancer specific survival and progression-free survival were the main outcomes of this study. The Kaplan-Meier method was used to calculate survival functions and differences were assessed with the log rank statistic. Univariable and multivariable Cox regression models addressed progression-free survival and cancer specific survival. Results: Median followup of the patients undergoing traditional partial nephrectomy and simple enucleation was 51 ± 37.8 and 54.4 ± 36 months, respectively (p = 0.08). The 5 and 10-year progression-free survival estimates were 88.9 and 82% after standard partial nephrectomy, and 91.4% and 90.8% after simple enucleation (p = 0.09). The 5 and 10-year cancer specific survival estimates were 93.9% and 91.6% after standard partial nephrectomy, and 94.3% and 93.2% after simple enucleation (p = 0.94). On multivariable analysis the adopted nephron sparing surgery technique was not an independent predictor of progression-free survival (HR 0.8, p = 0.55) and cancer specific survival (HR 0.7, p = 0.53) when adjusted for the effect of the other covariates. Conclusions: To our knowledge this is the first multicenter, comparative study showing oncologic equivalence of standard partial nephrectomy and simple enucleation.

Original languageEnglish
Pages (from-to)1604-1610
Number of pages7
JournalJournal of Urology
Volume185
Issue number5
DOIs
Publication statusPublished - May 2011

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Nephrectomy
Renal Cell Carcinoma
Retrospective Studies
Disease-Free Survival
Survival
Neoplasms
Nephrons
Proportional Hazards Models
Multicenter Studies
Outcome Assessment (Health Care)
Kidney
Recurrence

Keywords

  • carcinoma
  • nephrectomy
  • renal cell

ASJC Scopus subject areas

  • Urology

Cite this

Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma : Results of a nonrandomized, retrospective, comparative study. / Minervini, Andrea; Ficarra, Vincenzo; Rocco, Francesco; Antonelli, Alessandro; Bertini, Roberto; Carmignani, Giorgio; Cosciani Cunico, Sergio; Fontana, Dario; Longo, Nicola; Martorana, Giuseppe; Mirone, Vincenzo; Morgia, Giuseppe; Novara, Giacomo; Roscigno, Marco; Schiavina, Riccardo; Serni, Sergio; Simeone, Claudio; Simonato, Alchiede; Siracusano, Salvatore; Volpe, Alessandro; Zattoni, Filiberto; Zucchi, Alessandro; Carini, Marco; De Cobelli, O.; Corti, S.; Castelli, M.; Cimino, S.; Favilla, V.; Billia, M.; Terrone, C.; Imbimbo, C.; Masieri, L.; Oneto, F.; Varca, V.; Valotto, C.; Costantini, E.; Porena, M.; Ciciliato, S.; Lampropoulou, N.; Gontero, P.; Tizzani, A.; Artibani, W.; Brunelli, M.; Martignoni, G.; Bertini, R.; Montorsi, F.; Petralia, G.; Roscigno, M.; Strada, E.

In: Journal of Urology, Vol. 185, No. 5, 05.2011, p. 1604-1610.

Research output: Contribution to journalArticle

Minervini, A, Ficarra, V, Rocco, F, Antonelli, A, Bertini, R, Carmignani, G, Cosciani Cunico, S, Fontana, D, Longo, N, Martorana, G, Mirone, V, Morgia, G, Novara, G, Roscigno, M, Schiavina, R, Serni, S, Simeone, C, Simonato, A, Siracusano, S, Volpe, A, Zattoni, F, Zucchi, A, Carini, M, De Cobelli, O, Corti, S, Castelli, M, Cimino, S, Favilla, V, Billia, M, Terrone, C, Imbimbo, C, Masieri, L, Oneto, F, Varca, V, Valotto, C, Costantini, E, Porena, M, Ciciliato, S, Lampropoulou, N, Gontero, P, Tizzani, A, Artibani, W, Brunelli, M, Martignoni, G, Bertini, R, Montorsi, F, Petralia, G, Roscigno, M & Strada, E 2011, 'Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma: Results of a nonrandomized, retrospective, comparative study', Journal of Urology, vol. 185, no. 5, pp. 1604-1610. https://doi.org/10.1016/j.juro.2010.12.048
Minervini, Andrea ; Ficarra, Vincenzo ; Rocco, Francesco ; Antonelli, Alessandro ; Bertini, Roberto ; Carmignani, Giorgio ; Cosciani Cunico, Sergio ; Fontana, Dario ; Longo, Nicola ; Martorana, Giuseppe ; Mirone, Vincenzo ; Morgia, Giuseppe ; Novara, Giacomo ; Roscigno, Marco ; Schiavina, Riccardo ; Serni, Sergio ; Simeone, Claudio ; Simonato, Alchiede ; Siracusano, Salvatore ; Volpe, Alessandro ; Zattoni, Filiberto ; Zucchi, Alessandro ; Carini, Marco ; De Cobelli, O. ; Corti, S. ; Castelli, M. ; Cimino, S. ; Favilla, V. ; Billia, M. ; Terrone, C. ; Imbimbo, C. ; Masieri, L. ; Oneto, F. ; Varca, V. ; Valotto, C. ; Costantini, E. ; Porena, M. ; Ciciliato, S. ; Lampropoulou, N. ; Gontero, P. ; Tizzani, A. ; Artibani, W. ; Brunelli, M. ; Martignoni, G. ; Bertini, R. ; Montorsi, F. ; Petralia, G. ; Roscigno, M. ; Strada, E. / Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma : Results of a nonrandomized, retrospective, comparative study. In: Journal of Urology. 2011 ; Vol. 185, No. 5. pp. 1604-1610.
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abstract = "Purpose: The excision of the renal tumor with a substantial margin of healthy parenchyma is considered the gold standard technique for partial nephrectomy. However, simple enucleation showed excellent results in some retrospective series. We compared the oncologic outcomes after standard partial nephrectomy and simple enucleation. Materials and Methods: We retrospectively analyzed 982 patients who underwent standard partial nephrectomy and 537 who had simple enucleation for localized renal cell carcinoma at 16 academic centers between 1997 and 2007. Local recurrence, cancer specific survival and progression-free survival were the main outcomes of this study. The Kaplan-Meier method was used to calculate survival functions and differences were assessed with the log rank statistic. Univariable and multivariable Cox regression models addressed progression-free survival and cancer specific survival. Results: Median followup of the patients undergoing traditional partial nephrectomy and simple enucleation was 51 ± 37.8 and 54.4 ± 36 months, respectively (p = 0.08). The 5 and 10-year progression-free survival estimates were 88.9 and 82{\%} after standard partial nephrectomy, and 91.4{\%} and 90.8{\%} after simple enucleation (p = 0.09). The 5 and 10-year cancer specific survival estimates were 93.9{\%} and 91.6{\%} after standard partial nephrectomy, and 94.3{\%} and 93.2{\%} after simple enucleation (p = 0.94). On multivariable analysis the adopted nephron sparing surgery technique was not an independent predictor of progression-free survival (HR 0.8, p = 0.55) and cancer specific survival (HR 0.7, p = 0.53) when adjusted for the effect of the other covariates. Conclusions: To our knowledge this is the first multicenter, comparative study showing oncologic equivalence of standard partial nephrectomy and simple enucleation.",
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TY - JOUR

T1 - Simple enucleation is equivalent to traditional partial nephrectomy for renal cell carcinoma

T2 - Results of a nonrandomized, retrospective, comparative study

AU - Minervini, Andrea

AU - Ficarra, Vincenzo

AU - Rocco, Francesco

AU - Antonelli, Alessandro

AU - Bertini, Roberto

AU - Carmignani, Giorgio

AU - Cosciani Cunico, Sergio

AU - Fontana, Dario

AU - Longo, Nicola

AU - Martorana, Giuseppe

AU - Mirone, Vincenzo

AU - Morgia, Giuseppe

AU - Novara, Giacomo

AU - Roscigno, Marco

AU - Schiavina, Riccardo

AU - Serni, Sergio

AU - Simeone, Claudio

AU - Simonato, Alchiede

AU - Siracusano, Salvatore

AU - Volpe, Alessandro

AU - Zattoni, Filiberto

AU - Zucchi, Alessandro

AU - Carini, Marco

AU - De Cobelli, O.

AU - Corti, S.

AU - Castelli, M.

AU - Cimino, S.

AU - Favilla, V.

AU - Billia, M.

AU - Terrone, C.

AU - Imbimbo, C.

AU - Masieri, L.

AU - Oneto, F.

AU - Varca, V.

AU - Valotto, C.

AU - Costantini, E.

AU - Porena, M.

AU - Ciciliato, S.

AU - Lampropoulou, N.

AU - Gontero, P.

AU - Tizzani, A.

AU - Artibani, W.

AU - Brunelli, M.

AU - Martignoni, G.

AU - Bertini, R.

AU - Montorsi, F.

AU - Petralia, G.

AU - Roscigno, M.

AU - Strada, E.

PY - 2011/5

Y1 - 2011/5

N2 - Purpose: The excision of the renal tumor with a substantial margin of healthy parenchyma is considered the gold standard technique for partial nephrectomy. However, simple enucleation showed excellent results in some retrospective series. We compared the oncologic outcomes after standard partial nephrectomy and simple enucleation. Materials and Methods: We retrospectively analyzed 982 patients who underwent standard partial nephrectomy and 537 who had simple enucleation for localized renal cell carcinoma at 16 academic centers between 1997 and 2007. Local recurrence, cancer specific survival and progression-free survival were the main outcomes of this study. The Kaplan-Meier method was used to calculate survival functions and differences were assessed with the log rank statistic. Univariable and multivariable Cox regression models addressed progression-free survival and cancer specific survival. Results: Median followup of the patients undergoing traditional partial nephrectomy and simple enucleation was 51 ± 37.8 and 54.4 ± 36 months, respectively (p = 0.08). The 5 and 10-year progression-free survival estimates were 88.9 and 82% after standard partial nephrectomy, and 91.4% and 90.8% after simple enucleation (p = 0.09). The 5 and 10-year cancer specific survival estimates were 93.9% and 91.6% after standard partial nephrectomy, and 94.3% and 93.2% after simple enucleation (p = 0.94). On multivariable analysis the adopted nephron sparing surgery technique was not an independent predictor of progression-free survival (HR 0.8, p = 0.55) and cancer specific survival (HR 0.7, p = 0.53) when adjusted for the effect of the other covariates. Conclusions: To our knowledge this is the first multicenter, comparative study showing oncologic equivalence of standard partial nephrectomy and simple enucleation.

AB - Purpose: The excision of the renal tumor with a substantial margin of healthy parenchyma is considered the gold standard technique for partial nephrectomy. However, simple enucleation showed excellent results in some retrospective series. We compared the oncologic outcomes after standard partial nephrectomy and simple enucleation. Materials and Methods: We retrospectively analyzed 982 patients who underwent standard partial nephrectomy and 537 who had simple enucleation for localized renal cell carcinoma at 16 academic centers between 1997 and 2007. Local recurrence, cancer specific survival and progression-free survival were the main outcomes of this study. The Kaplan-Meier method was used to calculate survival functions and differences were assessed with the log rank statistic. Univariable and multivariable Cox regression models addressed progression-free survival and cancer specific survival. Results: Median followup of the patients undergoing traditional partial nephrectomy and simple enucleation was 51 ± 37.8 and 54.4 ± 36 months, respectively (p = 0.08). The 5 and 10-year progression-free survival estimates were 88.9 and 82% after standard partial nephrectomy, and 91.4% and 90.8% after simple enucleation (p = 0.09). The 5 and 10-year cancer specific survival estimates were 93.9% and 91.6% after standard partial nephrectomy, and 94.3% and 93.2% after simple enucleation (p = 0.94). On multivariable analysis the adopted nephron sparing surgery technique was not an independent predictor of progression-free survival (HR 0.8, p = 0.55) and cancer specific survival (HR 0.7, p = 0.53) when adjusted for the effect of the other covariates. Conclusions: To our knowledge this is the first multicenter, comparative study showing oncologic equivalence of standard partial nephrectomy and simple enucleation.

KW - carcinoma

KW - nephrectomy

KW - renal cell

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