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Nephron Sparing Surgery Associated With Better Survival Than Radical Nephrectomy in Patients Treated for Unforeseen Benign Renal Tumors

Ljungberg, Börje; Hedin, Oskar; Lundstam, Sven; Warnolf, Åsa; Forsberg, Annika Mandahl; Hjelle, Karin M.; Stief, Christian G.; Borlinghaus, Claudia; Beisland, Christian and Staehler, Michael (2015) In Urology
Abstract

Introduction: To evaluate the role of the surgical technique used for the treatment of benign renal tumors, with regard to renal function and overall survival (OS) in patients without cancer-related mortality. Technical considerations: The study included 506 patients, mean age of 63.3 years, with histologically proven benign renal lesions originating from 5 European centers. Retrospective data from each hospital were retrieved and merged into a common database for analyses. OS, American Society of Anesthesiology score, and renal functions were measured in relation to surgical technique. The Mann-Witney U-test, the paired t-test, and Cox's multivariate analysis were used.Patients treated with radical nephrectomy had significantly reduced... (More)

Introduction: To evaluate the role of the surgical technique used for the treatment of benign renal tumors, with regard to renal function and overall survival (OS) in patients without cancer-related mortality. Technical considerations: The study included 506 patients, mean age of 63.3 years, with histologically proven benign renal lesions originating from 5 European centers. Retrospective data from each hospital were retrieved and merged into a common database for analyses. OS, American Society of Anesthesiology score, and renal functions were measured in relation to surgical technique. The Mann-Witney U-test, the paired t-test, and Cox's multivariate analysis were used.Patients treated with radical nephrectomy had significantly reduced renal function postoperatively compared with nephron sparing surgery (NSS). OS was significantly reduced after radical nephrectomy compared with NSS (P = .012), a survival difference that remained significant [hazard ratio (HR) 0.042, 95% confidence interval (CI) 0.221-0.972, P = .042] in multivariate analysis, together with age at diagnosis (HR 1.065, 95% CI 1.026-1.106, P = .001) and American Society of Anesthesiology score (HR 2.361, 95% CI 1.261-4.419, P = .007). Also renal function assessed by estimated glomerular filtration rate significantly correlated to survival in univariate analysis, but did not remain independent after multivariate analysis. Oncocytoma was the most frequent benign lesion, followed by angiomyolipoma. Conclusion: The present study in patients with benign renal tumors shows that the remaining renal function and OS correspond to the choice of surgical procedure. Our results support the recommendation to perform NSS whenever possible when surgery is performed for patients with renal masses. The limitations of the study are the retrospective design and the selection bias for the surgical approach.

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author
publishing date
type
Contribution to journal
publication status
in press
subject
keywords
renal tumors, nephron sparing
in
Urology
publisher
Elsevier
external identifiers
  • Scopus:84964904913
ISSN
0090-4295
DOI
10.1016/j.urology.2016.01.037
language
English
LU publication?
no
id
55e5a881-1a75-4904-a5ea-2d49b2125518
date added to LUP
2016-06-01 14:32:47
date last changed
2016-11-17 12:18:51
@misc{55e5a881-1a75-4904-a5ea-2d49b2125518,
  abstract     = {<p>Introduction: To evaluate the role of the surgical technique used for the treatment of benign renal tumors, with regard to renal function and overall survival (OS) in patients without cancer-related mortality. Technical considerations: The study included 506 patients, mean age of 63.3 years, with histologically proven benign renal lesions originating from 5 European centers. Retrospective data from each hospital were retrieved and merged into a common database for analyses. OS, American Society of Anesthesiology score, and renal functions were measured in relation to surgical technique. The Mann-Witney U-test, the paired t-test, and Cox's multivariate analysis were used.Patients treated with radical nephrectomy had significantly reduced renal function postoperatively compared with nephron sparing surgery (NSS). OS was significantly reduced after radical nephrectomy compared with NSS (P = .012), a survival difference that remained significant [hazard ratio (HR) 0.042, 95% confidence interval (CI) 0.221-0.972, P = .042] in multivariate analysis, together with age at diagnosis (HR 1.065, 95% CI 1.026-1.106, P = .001) and American Society of Anesthesiology score (HR 2.361, 95% CI 1.261-4.419, P = .007). Also renal function assessed by estimated glomerular filtration rate significantly correlated to survival in univariate analysis, but did not remain independent after multivariate analysis. Oncocytoma was the most frequent benign lesion, followed by angiomyolipoma. Conclusion: The present study in patients with benign renal tumors shows that the remaining renal function and OS correspond to the choice of surgical procedure. Our results support the recommendation to perform NSS whenever possible when surgery is performed for patients with renal masses. The limitations of the study are the retrospective design and the selection bias for the surgical approach.</p>},
  author       = {Ljungberg, Börje and Hedin, Oskar and Lundstam, Sven and Warnolf, Åsa and Forsberg, Annika Mandahl and Hjelle, Karin M. and Stief, Christian G. and Borlinghaus, Claudia and Beisland, Christian and Staehler, Michael},
  issn         = {0090-4295},
  keyword      = {renal tumors,nephron  sparing },
  language     = {eng},
  month        = {11},
  publisher    = {ARRAY(0x9b02370)},
  series       = {Urology},
  title        = {Nephron Sparing Surgery Associated With Better Survival Than Radical Nephrectomy in Patients Treated for Unforeseen Benign Renal Tumors},
  url          = {http://dx.doi.org/10.1016/j.urology.2016.01.037},
  year         = {2015},
}