Partial nephrectomy (PN) is superior to radical nephrectomy (RN) in preserving renal function even when tumors are larger than the traditional 4 cm cutoff, a new study suggests.

Géraldine Pignot, MD, PhD, of Bicetre Hospital, Paris XI University, Le Kremlin Bicêtre, France, and colleagues analyzed data from 973 patients with renal tumors. The tumors were 4 cm or smaller in 665 cases (68.3%) and larger than 4 cm in 308 cases (31.7%).


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Surgeons performed PN in 663 cases (68.1%) and RN in 310 (31.9%). Patients who underwent PN had a smaller risk for experiencing significant changes in glomerular filtration rate (GFR) regardless of tumor size, according to findings published online ahead of print in Urologic Oncology.


In multivariate analysis, the use of RN, a preoperative GFR below 60 mL/min/1.73 m2, a tumor size larger than 4 cm, and older age at diagnosis independently predicted significant postoperative GFR loss.