RN-treated subjects were twice as likely as NSS-treated subjects to experience a significant decline in eGFR regardless of tumor size, Dr. Patard told attendees. In addition, subjects with a preoperative eGFR less than 60 had a nearly five times increased risk of a significant GFR decline as patients with a preoperative eGFR of 60 or higher. Patients aged 60 years and older had a nearly twofold increased risk of eGFR decrease as younger patients.
The other study, presented by R. Houston Thompson, MD, a urology resident at Memorial Sloan-Kettering Cancer Center in New York, included 1,159 patients with renal masses 4-7 cm in diameter. Of these, 873 (75%) and 286 (25%) were treated with RN and partial nephrectomy (PN), respectively. PN-treated patients were significantly more likely to have a solitary kidney compared with RN-treated patients (10% vs. 0.2%) and more likely to have impaired baseline renal function (15% vs. 7%).
The study group had a mean follow-up duration of 5.7 years. At last follow-up, 345 patients had died. Both groups had similar overall and cancer-specific survival, even after adjusting for age, Charlson index, tumor size, impaired renal function, and malignant histology, Dr. Thompson reported.
Furthermore, in a subgroup of 943 patients with renal cell carcinoma whose cause of death could be determined, RN-treated patients had a significant twofold increased risk of cancer-related death compared with PN-treated patients. Dr. Thompson cautioned, however, that because the study was retrospective, he and his team could not control for patient selection bias, and this could have influenced the study’s findings in favor of PN.
He concluded that PN at least does not compromise overall and cancer-specific survival in patients with renal tumors up to 7 cm in size.