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