Partial nephrectomy for T3aN0M0 renal cell carcinoma: shall we step forward?

Peng, Ding; He, Zhi-song; Li, Xue-song; Tang, Qi; Zhang, Lei; Yang, Kai-wei; Yu, Xiao-teng; Zhang, Cui-jian; Zhou, Li-qun

doi:10.1590/S1677-5538.IBJU.2016.0598

Ding Peng

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Zhi-song He

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Xue-song Li

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Qi Tang

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Lei Zhang

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Kai-wei Yang

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Xiao-teng Yu

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Cui-jian Zhang

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Li-qun Zhou Correspondence address: Li-qun Zhou, MD, Department of Urology, Inst. of Urology, Peking Univ. First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, China, Fax: +86 10 6655-1726 E-mail: zhouliqunmail@sina.com

Department of Urology, Institute of Urology, Peking University First Hospital, Beijing, China

Correspondence address: Li-qun Zhou, MD, Department of Urology, Inst. of Urology, Peking Univ. First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, China, Fax: +86 10 6655-1726 E-mail: zhouliqunmail@sina.com

CONFLICT OF INTEREST

None declared.

Ding Peng and Zhi-song He contributed equally to this work

Criterion	Difference allowed
Age	<10 years
Gender	Identical
Tumor size	<3 cm
ASA score	Identical
Pathological subtype	Identical
Tumor invasion status	Identical
Surgical margin status	Identical
Fuhrman grade	Identical

Variable		RN	PN	P
Age		64.94±12.62	60.89±13.99	0.368
Male gender		14	14	Matched
Histopathologic subtype				Matched
	ccRCC	13	13
	non-ccRCC	5	5
Fuhrman grade				Matched
	1	1	1
	2	11	11
	3	6	6
ASA score				Matched
	1	1	1
	2	13	13
	3	4	4
Tumor size		5.03±1.42	5.27±1.50	0.644
Tumor invasion				Matched
	Fat	17	17
	Renal vein	1	1
Surgical margin				Matched
	Positive	1	1
	Negative	17	17
Blood loss (mL)		248.89±570.22	287.22±598.03	0.845
Operative time (min)		157.44±45.04	131.61±49.39	0.110
Indwelling drainage tube time (day)		4.94±4.14	4.61±2.77	0.778
Postoperative stay (days)		7.61±2.50	6.44±3.41	0.250
Preoperative eGFR (mL/min/1.73m²)		82.60±26.53	73.99±27.97	0.357
Postoperative eGFR (mL/min/1.73m²)		52.35±17.21	68.38±24.40	0.034 ^* * P<0.05

Variable		n		CSS			RFS
			CSS	χ²	P	RFS	χ²	P
Gender				2.067	0.151		2.840	0.092
	Male	87	65.4			53.1
	Female	38	74.2			69.7
Age, years				0.736	0.391		0.400	0.527
	<55	49	69.6			59.1
	≥55	76	67.5			57.7
BMI				0.146	0.703		0.230	0.632
	<25	68	64.3			59.8
	≥25	57	72.8			55.9
Tumor invasion				9.772	0.002 ^* * P<0.05		4.231	0.040 ^* * P<0.05
	Fat	89	78.6			64.6
	Renal vein	36	46.3			42.9
	Histopathologic			0.267	0.605		0.801	0.371
	subtype
	ccRCC	111	68.3			56.0
	non-ccRCC	14	68.8			77.4
	Location			1.206	0.272		0.905	0.341
	Left	66	62.9			54.9
	Right	59	74.4			62.9
Tumor size, cm				0.007	0.935		0.310	0.578
	≤4	9	83.3			58.3
	>4	116	68.9			57.8
Fuhrman grade				8.968	0.003 ^* * P<0.05		16.623	<0.001 ^* * P<0.05
	1&2	60	85.7			79.6
	3&4	65	53.9			39.5
ASA score				0.000	0.993		0.834	0.361
	1&2	113	67.4			58.6
	3&4	12	76.2			60.0
Surgical type				0.021	0.885		0.101	0.751
	RN	107	67.3			56.6
	PN	18	80.5			76
Surgical margin				46.172	<0.001 ^* * P<0.05		16.169	<0.001 ^* * P<0.05
	Positive	2	0			0
	Negative	123	69.1			59.2
Surgical approach				0.061	0.805		2.023	0.155
	Open	80	67.2			54.5
	Laparoscopic	45	74			67.8
Hypoalbuminaemia				10.934	0.001 ^* * P<0.05		4.394	0.036 ^* * P<0.05
	No	115	71.9			60.2
	Yes	10	20			28.6
Anemia				22.03	<0.001 ^* * P<0.05		13.349	<0.001 ^* * P<0.05
	No	102	75.6			63.7
	Yes	23	33			29.8

Variable			CSS			RFS
		HR	(95% CI)	P	HR	(95% CI)	P
Tumor invasion
	Fat	1			1
	Renal vein	1.386	0.580-3.315	0.463	1.201	0.593-2.432	0.610
Fuhrman grade
	1&2	1			1
	3&4	1.865	0.701-4.961	0.212	3.688	1.651-8.239	0.001 ^* * P<0.05
Surgical margin
	Positive	41.318	6.686-255.331	<0.001 ^* * P<0.05	10.861	2.231-52.873	0.003 ^* * P<0.05
	Negative	1			1
Serum album, g/L
	≥35	1			1
	<35	1.678	0.580-4.855	0.339	1.300	0.431-3.922	0.642
Anemia
	No	1			1
	Yes	3.633	1.546-8.537	0.003 ^* * P<0.05	3.201	1.464-7.000	0.004 ^* * P<0.05

[1] Correspondence address: Li-qun Zhou, MD, Department of Urology, Inst. of Urology, Peking Univ. First Hospital, No. 8, Xishiku Street, Xicheng District, Beijing, 100034, China, Fax: +86 10 6655-1726 E-mail: zhouliqunmail@sina.com

Brasil

Brasil

Partial nephrectomy for T3aN0M0 renal cell carcinoma: shall we step forward?

ABSTRACT

Objectives:

Patients and Methods:

Results:

Conclusions: