Large renal tumors: PN, RN yield similar CSS in meta-analysis

  • Deng W & et al.
  • Urol Oncol
  • 28 Jan 2019

  • curated by Deepa Koli
  • Univadis Clinical Summaries
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Takeaway

  • Patients with large (≥7 cm) renal tumors undergoing partial nephrectomy (PN) showed OS benefit vs those receiving radical nephrectomy (RN), but cancer-specific survival (CSS) was similar between groups.
  • PN was associated with less deterioration of renal function, but significantly higher risk of surgical complications than RN.

Why this matters

  • PN is the preferred treatment for small renal masses, but less is known about its role in protecting renal function without compromising oncologic outcomes in large renal tumors.

Study design

  • Meta-analysis of 13 studies including 2906 patients with large renal tumors who underwent PN (n=1172) or RN (n=1734).
  • Funding: None.

Key results

  • Follow-up duration range, 24-163 months.
  • OS was significantly higher in patients undergoing PN vs RN (HR, 0.76; P=.001).
  • Cancer-specific survival was similar between the groups (HR, 0.91; P=.51).
  • The pooled decrease in estimated glomerular filtration rate was significantly lower in the PN group (mean difference [MD], 11.59; P<.001>
  • PN was associated with:
    • longer operative time (MD, 65.33 minutes, P≤.001),
    • higher estimated blood loss (MD, 97.75 mL; P≤.001),
    • higher risk for overall (OR, 2.82; P<.001 low-grade p=".01)," and high-grade surgical complications.>

Limitations

  • Retrospective studies were included.

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