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Artículo Tomo 70, Número. 7, Septiembre 2017

Archivos Españoles de Urología

Overall survival and renal function after partial and radical nephrectomy in malignant localized renal tumors.

Authors: Paula León-Medina, Carolina Artiles-Ortega, José Vicente Armas-Molina y José Luis Artiles-Hernández.

Arch. Esp. Urol. 2017; 70 (7): 654-661

Vol. 70, Number. 7, September 2017

OBJECTIVE: To evaluate the overall survival rate and renal function in our series after radical nephrectomy (RN) and partial nephrectomy (PN) in renal tumors in an early stage.

METHODS: We retrospectively reviewed the medical records of 229 patients who underwent RN or PN for renal cancer T1-T2N0M0 in our center between 1995 and 2015. We described demographic factors, first symptom, TNM, histology, post-surgery data, recurrence rate and renal function. We utilized Fisher test, Chi square test and T-Student and we considered statistical significance when p<0.05.

RESULTS: 203 patients underwent RN and 26 PN. 39.4% of the tumors who received RN were T1bN0M0 and 76.92% of PN were T1aN0M0. We report nine complications grade II of modified Clavien System for RN and only one grade I for PN. We detected an 11.3% recurrence in RN and none in PN. 66% of patients from RN are alive today, 12.81% died as result of renal cancer and 22.7% suffered a non-cancer-specific death. No deaths were observed in PN group. We observed similar mean preoperative serum creatinine (Cr) in both groups. Creatinine after the first post-operative month was 1.81mg/dL and 1.06mg/dL for RN and PN, respectively; At one year post-operative we registered Cr 1.82mg/dL and Cr 0.97mg/dL, respectively.

CONCLUSIONS: Both methods provide excellent oncologic results for renal carcinoma in an early stage. PN is safe and reduces the incidence of renal dysfunction with a lower rate of non-cancer-specific death.


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