Comparison of survival rates in stage 1 renal cell carcinoma between partial nephrectomy and radical nephrectomy patients according to age distribution: a propensity score matching study. (2nd July 2015)

• Record Type: Journal Article
• Authors: Takagi, Toshio; Kondo, Tsunenori; Iizuka, Junpei; Omae, Kenji; Kobayashi, Hirohito; Yoshida, Kazuhiko; Hashimoto, Yasunobu; Tanabe, Kazunari
• Is Part Of: BJU international. Volume 117:Number 6B(2016:Jun.)
• Page Start: E52
• Page End: E59
• Publication Date: 2015-07-02
• Subjects: nephrectomy -- kidney function -- kidney disease -- chronic; Genitourinary organs -- Diseases -- Periodicals; Genitourinary organs -- Surgery -- Periodicals; Urology -- Periodicals; 616.6
• DOI: 10.1111/bju.13200
• Languages: English
• ISSNs: 1464-4096

Abstract

Abstract : Objective: To assess differences in overall survival (OS) between patients receiving partial nephrectomy (PN) and radical nephrectomy (RN) for stage 1 renal cell carcinoma (RCC) according to age distribution, as the survival advantage of PN vs RN has been unclear owing to conflicting data. Patients and Methods: We studied 952 patients with stage 1 RCC who underwent either PN or RN. Patients were divided into three groups according to age: Group 1 (≤54 years), Group 2 (55–64 years), and Group 3 (≥65 years). Patient variables including age, body mass index, sex, presence of hypertension (HT) and/or diabetes mellitus (DM), performance status, tumour size, pathological diagnosis, nuclear grade, and preoperative estimated glomerular filtration rate (eGFR), were adjusted using 1:1 propensity score matching between PN and RN. Results: Group 1 included 66 matched patients; Group 2, 72; and Group 3, 70. Group 1 tended to have higher preoperative eGFR values and lower rates of HT and DM compared with Groups 2 and 3. Postoperative eGFR dropped by 11–13% in PN patients and by 34–36% in RN patients. In Group 3, PN patients had longer OS than RN patients (5‐year OS: PN 96%, RN 81%, P = 0.043); however, there was no significant difference in Group 1 (5‐year OS: PN 100%, RN 93%, P = 0.302) or Group 2 (5‐year OS: PN 94%, RN 87%, P = 0.358). Conclusions: Only the oldest group of patients showed significantly better OS for PN compared with RN; however, we still recommend PN in young patients.