The authors analyzed 3,320 patients with pT1a or pT1b kidney cancer from 16 academic centers within the SATUTN project (Surveillance And Treatment Update Renal Neoplasms). Of 1,832 patients with a pT1a tumor, 44.8% were treated with radical nephrectomy and 55.2% with partial nephrectomy. Most clinical parameters such as age, gender, mode of presentation, tumor size histologic subtype and Fuhrman grade were different between the two groups. The 5-year cancer-specific survival (CSS) rates for radical and partial nephrectomy were 96.3% and 96.6%, respectively. On multivariate analysis only age and Fuhrman grade were independent predictors of CSS. Of 1,388 patients with a pT1b tumor, 84.9% were treated with radical nephrectomy and 15.1% with partial nephrectomy. Most clinical parameters such as age, ECOG performance status, mode of presentation, tumor size, histologic subtype and Fuhrman grade were different between the two groups. The 5-year cancer-specific survival rates for radical and partial nephrectomy were 95.6% and 94.7%, respectively. On multivariate analysis only age, tumor multifocality and Fuhrman grade were independent predictors of CSS. For both tumor stages, types of surgery were not independent prognostic factors for CSS. The authors concluded that radical and partial nephrectomy have overlapping results for CSS, and partial nephrectomy for tumors larger than 4 cm may be considered as a valuable treatment.
This study provides additional data that oncological outcomes of partial nephrectomy and radical nephrectomy are similar. However, overall survival seems to be better following partial nephrectomy. Thus, partial nephrectomy should be performed whenever technically feasible.
Presented by Giacomo Novara, MD, FEBU, et al. at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria
Reported for UroToday by Christian Doehn, MD, PhD, Department of Urology, University of Lübeck Medical School, Lübeck Germany.
View EAU 2011 Annual Meeting Coverage
