Clinical Comparison Of Nephron-Sparing Surgery Versus Radical Nephrectomy In Patients With Lacalized Renal Cell Carcinomas

Objective To analyze and compare clinical outcomes for patients with localized renal cell carcinoma (RCC) undergoing nephron-sparing surgery(NSS) or radical nephrectomy (RN).Methods From2008to2013, we identified180patients in our clinic treated with either NSS or RN. After a median follow-up of29months (range3to72months) by telephone or referring to cases,137patients (32in the NSS group and105in the RN group) was remained for oncologic analysis. The studied groups were compared with respect to the patients’age, sex, symptoms at diagnosis, time of surgery, tumor size, TNM stage, postoperative duration, postoperative complication. Overall survival (OS), cancer-specific survival (CSS), progression-free survival (PFS) were estimated using the Kaplan-Meier method. Results During the study, for renal tumors≤4cm (n=51), the3-year and5-year cancer-specific survival was100%after NSS(n=27) and92.9%after RN(n=27),no difference in CSS was found between two groups(P=0.398).And for RCC stage pTla or greater(n=137),there were no significant differences between NSS(n=32) and RN(n=105) in OS, CSS, PFS (P>0.05)Conclusions Our study suggested that NSS is a safe and effective technique compared with RN that preserves the function of remaining nephron and ensures good oncologic control in the treatment of renal cell carcinoma stage pT1a or pT1b.