New study findings support the use of partial nephrectomy (PN) for treating selected patients with large renal masses, investigators concluded in a presentation at the 20th annual meeting of the Society of Urologic Oncology in Washington, DC.

The retrospective study by Matvey Tsivian, MD, and colleagues at Mayo Clinic in Rochester, Minnesota, included 446 patients who underwent either PN (73 patients) or radical nephrectomy (RN) (373 patients) for clinical T2 renal masses. The investigators matched the patients by propensity score. The groups were well balanced with regard to clinical and radiographic characteristics. The median follow-up time for survivors was 6.9 years.

The PN and RN patients had overall rates of complications of 19% and 13%, respectively, and 4% and 2% rates of severe complications, respectively, but the differences between the groups were not significant.


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The decline in estimated glomerular filtration rate (eGFR) at 1 and 3 years was significantly greater in the RN group (16 vs 5 and 13 vs 2 mL/min/1.73 m2, respectively), Dr Tsivian’s group reported. A significantly higher proportion of RN patients had new-onset eGFR below 60 mL/min/1.73 m2 at 1 and 3 years (55% vs 17% and 48% vs 17%, respectively).

In a subset of patients with renal cell carcinoma, PN and RN patients had comparable overall, cancer-specific, and metastasis-free survival rates, according to the investigators.

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Reference

Tsivian M, Packiam VT, Lohse CM, et al. Partial versus radical nephrectomy in clinical T2 renal masses. Presented at the 20th annual meeting of the Society of Urologic Oncology held December 4 to 6, 2019, in Washington, DC. Poster 64.