| Objective:To Compare of the difference efficacy and prognosis of partial nephrectomy(PN)and radical nephrectomy(RN)for T1 b renalcell carcinoma.Methods:Studies on relative English and Chinese database such as Pubmed,excerpta medica database(EMBASE),China biology medicinedisc(CBMdisc),China national knowledge infrastructure(CNKI),VIP database(VIP),WanFang,Web of science on studies comparing PN and RN for T1 b renal cell carcinoma between January 1,2000 and June30,2017 were searched.Stata 13.0 software was used to compare overall survival(OS)and the 5 years-cancer specific survival(CSS),the incidence of postoperative Chronic kidney disease(CKD)and the postoperative Glomerular filtration rate(GFR)decline between PN and RN.Results:Thirteen papers were included in the literature,with a total of 34908 patients,4051 of PN group,and 30857 of RN group.There was no significant difference between the PN group and RN group regarding the 5-year CSS and OS(P>0.05).The incidence of CKD after PN group was lower than RN,and the difference was statistically significant(OR =0.38,95% CI: 0.28~ 0.51).The decrease of GFR in PN group was lower than RN group,and the difference was statistically significant(SMD =-0.46,95% CI:-0.79~-0.14).Conclusion:Both PN and RN for stage T1 b renal cell carcinoma are safe and effective.On the premise of ensuring the treatment effect,PN retains as much kidney function as possible,reduces the incidence of chronic kidney disease,reduces the risk of cardiovascular disease caused by renal insufficiency after surgery,and improves the overall survival.Therefore,PN is currently the preferred surgical method for T1 b renal cell carcinoma. |
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