دورية أكاديمية
Assessing Functional Outcomes of Partial Versus Radical Nephrectomy for T1b-T2 Renal Masses: Results from a Multi-institutional Collaboration.
| العنوان: | Assessing Functional Outcomes of Partial Versus Radical Nephrectomy for T1b-T2 Renal Masses: Results from a Multi-institutional Collaboration. |
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| المؤلفون: | Tappero S; IRCCS Ospedale Policlinico San Martino, Genova, Italy. stefano.m.tappero@gmail.com.; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy. stefano.m.tappero@gmail.com.; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy. stefano.m.tappero@gmail.com., Bravi CA; Department of Urology, The Royal Marsden NHS Foundation Trust, London, UK.; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium.; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy., Khene ZE; Department of Urology, University of Rennes, Rennes, France., Campi R; Unit of Urological Robotic Surgery and Renal Transplantation, Careggi Hospital, University of Florence, Florence, Italy.; Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Pecoraro A; Department of Urology, Hospital Pederzoli, Peschiera del Garda, Verona, Italy., Diana P; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain., Re C; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy.; ASST-Sette Laghi, Circolo and Fondazione Macchi Hospital, University of Insubria, Varese, Italy., Giulioni C; Unit of Urology, Jesi Hospital, Jesi, Ancona, Italy.; Department of Urology, Polytechnic University of Marche Region, Ancona, Italy., Beksac AT; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Bertolo R; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Ajami T; Department of Urology, Hospital Clinic-IDIBAPS, University of Barcelona, Barcelona, Spain., Okhawere KE; Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA., Meagher M; University of California, San Diego, La Jolla, CA, USA., Alimohammadi A; Department of Urology, Medical University of Vienna, Vienna, Austria., Terrone C; IRCCS Ospedale Policlinico San Martino, Genova, Italy.; Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genova, Genova, Italy., Mari A; Unit of Oncologic Minimally-Invasive Urology and Andrology, Department of Clinical and Experimental Medicine, Careggi Hospital, University of Florence, Florence, Italy., Amparore D; Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy., Da Pozzo L; ASST Papa Giovanni XXIII, Bergamo, Italy.; School of Medicine, University of Milano-Bicocca, Milan, Italy., Anceschi U; Department of Urology, IRCCS 'Regina Elena' National Cancer Institute, Rome, Italy., Suardi N; Department of Urology, University of Brescia, Brescia, Italy., Galfano A; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy., Larcher A; Division of Oncology/Unit of Urology, URI, IRCCS Ospedale San Raffaele, Milan, Italy., Schiavina R; Division of Urology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Canda E; Department of Urology, Koç University Hospital, Istanbul, Turkey.; RMK AIMES, Rahmi M. Koç Academy of Interventional Medicine, Education, and Simulation, Istanbul, Turkey., Zhang X; Department of Urology, Chinese PLA General Hospital, Beijing, China., Shariat S; Department of Urology, Medical University of Vienna, Vienna, Austria., Porpiglia F; Department of Oncology, Division of Urology, University of Turin, San Luigi Gonzaga Hospital, Orbassano, Turin, Italy., Antonelli A; Department of Urology, University of Verona, Azienda Ospedaliera Universitaria Integrata, Verona, Italy., Kaouk J; Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, OH, USA., Badani K; Department of Urology, Icahn School of Medicine at Mount Sinai, New York City, NY, USA., Derweesh I; University of California, San Diego, La Jolla, CA, USA., Breda A; Department of Urology, Fundació Puigvert, Autonoma University of Barcelona, Barcelona, Spain., Mottrie A; Department of Urology, Onze-Lieve-Vrouwziekenhuis Hospital, Aalst, Belgium.; ORSI Academy, Ghent, Belgium., Dell'Oglio P; Department of Urology, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.; Department of Urology, Antoni van Leeuwenhoek Hospital, The Netherlands Cancer Institute, Amsterdam, The Netherlands.; Interventional Molecular Imaging Laboratory, Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands. |
| المصدر: | Annals of surgical oncology [Ann Surg Oncol] 2024 Aug; Vol. 31 (8), pp. 5465-5472. Date of Electronic Publication: 2024 May 27. |
| نوع المنشور: | Journal Article; Multicenter Study; Comparative Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Springer Country of Publication: United States NLM ID: 9420840 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1534-4681 (Electronic) Linking ISSN: 10689265 NLM ISO Abbreviation: Ann Surg Oncol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2005- : New York, NY : Springer Original Publication: New York, NY : Raven Press, c1994- |
| مواضيع طبية MeSH: | Nephrectomy*/methods , Kidney Neoplasms*/surgery , Kidney Neoplasms*/pathology , Glomerular Filtration Rate* , Acute Kidney Injury*/etiology , Postoperative Complications*, Humans ; Male ; Female ; Middle Aged ; Aged ; Follow-Up Studies ; Renal Insufficiency, Chronic/surgery ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Survival Rate ; Carcinoma, Renal Cell/surgery ; Carcinoma, Renal Cell/pathology |
| مستخلص: | Background: Deterioration of renal function is associated with increased all-cause mortality. In renal masses larger than 4 cm, whether partial versus radical nephrectomy (PN vs. RN) might affect long-term functional outcomes is unknown. This study tested the association between PN versus RN and postoperative acute kidney injury (AKI), recovery of at least 90% of the preoperative estimated glomerular filtration rate (eGFR) at 1 year, upstaging of chronic kidney disease (CKD) one stage or more at 1 year, and eGFR decline of 45 ml/min/1.73 m 2 or less at 1 year. Methods: Data from 23 high-volume institutions were used. The study included only surgically treated patients with single, unilateral, localized, clinical T1b-2 renal masses. Multivariable logistic regression analyses were performed. Results: Overall, 968 PN patients and 325 RN patients were identified. The rate of AKI was lower in the PN versus the RN patients (17% vs. 58%; p < 0.001). At 1 year after surgery, for the PN versus the RN patients, the rate for recovery of at least 90% of baseline eGFR was 51% versus 16%, the rate of CKD progression of ≥ 1 stage was 38% versus 65%, and the rate of eGFR decline of 45 ml/min/1.73 m 2 or less was 10% versus 23% (all p < 0.001). Radical nephrectomy independently predicted AKI (odds ratio [OR], 7.61), 1-year ≥ 90% eGFR recovery (OR, 0.30), 1-year CKD upstaging (OR, 1.78), and 1-year eGFR decline of 45 ml/min/1.73 m 2 or less (OR, 2.36) (all p ≤ 0.002). Conclusions: For cT1b-2 masses, RN portends worse immediate and 1-year functional outcomes. When technically feasible and oncologically safe, efforts should be made to spare the kidney in case of large renal masses to avoid the hazard of glomerular function loss-related mortality. (© 2024. Society of Surgical Oncology.) |
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| فهرسة مساهمة: | Keywords: Acute kidney injury; Creatinine; Long-term functional outcomes; Partial nephrectomy; Radical nephrectomy; Renal function |
| تواريخ الأحداث: | Date Created: 20240527 Date Completed: 20240712 Latest Revision: 20240716 |
| رمز التحديث: | 20240716 |
| DOI: | 10.1245/s10434-024-15305-w |
| PMID: | 38802714 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1534-4681 |
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| DOI: | 10.1245/s10434-024-15305-w |