Partial versus radical nephrectomy for renal cell carcinoma involving peri renal fat. Oncological and functional outcomes

In the latest guidelines of the European Association of Urology, partial nephrectomy was a reference standard in tumors less than 7cm confined to the kidney. The invasion of the perirenal fat and therefore dissection in a potentially tumor tissue with an increased risk of recurrence. From 1995 to 20...

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Published inProgrès en urologie (Paris) Vol. 22; no. 7; p. 388
Main Authors Polo, G, Crouzet, S, Poissonnier, L, Roux, A, Deculier, E, Martin, X, Badet, L
Format Journal Article
LanguageFrench
Published France 01.06.2012
Subjects
Adult
Aged
Aged, 80 and over
Carcinoma, Renal Cell - pathology
Carcinoma, Renal Cell - surgery
Female
Humans
Kidney Neoplasms - pathology
Kidney Neoplasms - surgery
Male
Middle Aged
Neoplasm Invasiveness
Nephrectomy - methods
Retrospective Studies
Treatment Outcome
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Summary:In the latest guidelines of the European Association of Urology, partial nephrectomy was a reference standard in tumors less than 7cm confined to the kidney. The invasion of the perirenal fat and therefore dissection in a potentially tumor tissue with an increased risk of recurrence. From 1995 to 2009, we retrospectively evaluated the oncological outcomes of partial versus radical nephrectomy in tumors with local extension beyond the boundaries of the kidney, without adrenal involvement or metastatic lymph node extension. We evaluated the histological factors influencing the prognostic. A total of 43patients have been included (ten partial and 33radical nephrectomy). We did not found any significant difference in terms of specific and recurrence-free survival between partial and radical nephrectomy in tumor invading the perirenal fat (P=0.739 and P=0.683 respectively). Factors influencing the prognosis were the Fuhrman grade (P=0.010), the invasion of the urinary tract (P=0.017) and the presence of a positive surgical margin (P=0.041). The renal function was better after partial nephrectomy. The complication rate was similar between partial and radical nephrectomy. The perirenal fat invasion by kidney tumor did not impact the oncological outcomes of partial versus radical nephrectomy with better functional outcomes for partial nephrectomy.
ISSN:1166-7087
DOI:10.1016/j.purol.2012.01.018