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• W2023574066 abstract "No AccessJournal of UrologyAdult Urology1 Jan 2009Long-Term Outcomes After Nephron Sparing Surgery for Renal Cell Carcinoma Larger Than 4 cm Matthieu Peycelon, Vincent Hupertan, Eva Comperat, Raphaële Renard-Penna, Christophe Vaessen, Pierre Conort, Marc-Olivier Bitker, Emmanuel Chartier-Kastler, François Richard, and Morgan Rouprêt Matthieu PeycelonMatthieu Peycelon Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Vincent HupertanVincent Hupertan Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Eva ComperatEva Comperat Department of Pathology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Raphaële Renard-PennaRaphaële Renard-Penna Department of Radiology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Christophe VaessenChristophe Vaessen Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Pierre ConortPierre Conort Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Marc-Olivier BitkerMarc-Olivier Bitker Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , Emmanuel Chartier-KastlerEmmanuel Chartier-Kastler Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , François RichardFrançois Richard Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author , and Morgan RouprêtMorgan Rouprêt Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2008.09.025AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We determined the cancer control provided by nephron sparing surgery for renal cell carcinoma greater than 4 cm. Materials and Methods: We performed a retrospective review of data on patients treated between 1980 and 2005. The case characteristics analyzed were patient age, surgical procedure, intraoperative parameters, complications, tumor size, Fuhrman grade, TNM stage, pathological data and outcome. Kaplan-Meier survival curves were generated. Results: Median age of the 61 patients was 64 years (range 40 to 83). Mean ± SD intraoperative blood loss was 622 ml ± 691 (range 50 to 4,800) and mean operative time was 155.7 ± 82 minutes (range 52 to 360). Mean creatinine preoperatively and immediately postoperatively was 1.16 and 1.25 mg/dl, respectively. Mean renal cell carcinoma size was 56.3 ± 18 mm (range 41 to 100). Margin status was positive in 11 cases (18%). Median followup was 70.7 months. The 5 and 10-year cancer specific survival rate was 81% and 78%, respectively. The tumor-free survival rate was 92% at 5 years and 88% at 10 years. On univariate analysis tumor size more than 7 cm (p = 0.002), pathological stage (p = 0.001) and Fuhrman grade (p = 0.004) were associated with survival. On multivariate analysis only pathological stage and Fuhrman grade were significant (p <0.0001 and 0.007, respectively). Conclusions: Our results support the fact that nephron sparing surgery is a useful and acceptable approach to renal cell carcinoma greater than 4 cm. When technically possible, nephron sparing surgery provides acceptable long-term cancer specific survival rates. However, oncological safety is less evident in cases of renal cell carcinoma greater than 7 cm. To date in such cases nephron sparing surgery should only be considered for absolute indications. References 1 : Cancer statistics, 2006. CA Cancer J Clin2006; 56: 106. Google Scholar 2 : Renal cell carcinoma guideline. Eur Urol2007; 51: 1502. Google Scholar 3 : Comparison of laparoscopic radical and partial nephrectomy: effects on long-term serum creatinine. 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Link, Google Scholar © 2009 by American Urological AssociationFiguresReferencesRelatedDetailsCited byHew M, Baseskioglu B, Barwari K, Axwijk P, Can C, Horenblas S, Bex A, de la Rosette J and Laguna Pes M (2011) Critical Appraisal of the PADUA Classification and Assessment of the R.E.N.A.L. Nephrometry Score in Patients Undergoing Partial NephrectomyJournal of Urology, VOL. 186, NO. 1, (42-46), Online publication date: 1-Jul-2011.Gupta G, Peterson J, Thakore K, Pinto P, Linehan W and Bratslavsky G (2010) Oncological Outcomes of Partial Nephrectomy for Multifocal Renal Cell Carcinoma Greater Than 4 cmJournal of Urology, VOL. 184, NO. 1, (59-63), Online publication date: 1-Jul-2010. Volume 181Issue 1January 2009Page: 35-41 Advertisement Copyright & Permissions© 2009 by American Urological AssociationKeywordsrenal cellcarcinomakidneymortalityneoplasm recurrenceMetrics Author Information Matthieu Peycelon Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Vincent Hupertan Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Eva Comperat Department of Pathology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Raphaële Renard-Penna Department of Radiology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Christophe Vaessen Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Pierre Conort Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Marc-Olivier Bitker Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Emmanuel Chartier-Kastler Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author François Richard Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Morgan Rouprêt Department of Urology, Groupement Hospitalier Universitaire Est (Pitié-Tenon), Assistance-Publique Hôpitaux de Paris and Faculté de Médecine Pierre et Marie Curie, University Paris VI, Paris, France More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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