1086 THE INCREASED UTILIZATION OF PARTIAL NEPHRECTOMY FOR PATIENTS WITH RENAL CELL CARCINOMA WITH THE NORMAL CONTRALATERAL KIDNEY - THE INFLUENCE OF TUMOR SIZE ON THE CHOICE OF SURGICAL PROCEDURE IN THIS EXPERT SINGLE CENTER

Abstract

You have accessJournal of UrologyKidney Cancer: Localized1 Apr 20111086 THE INCREASED UTILIZATION OF PARTIAL NEPHRECTOMY FOR PATIENTS WITH RENAL CELL CARCINOMA WITH THE NORMAL CONTRALATERAL KIDNEY - THE INFLUENCE OF TUMOR SIZE ON THE CHOICE OF SURGICAL PROCEDURE IN THIS EXPERT SINGLE CENTER Tsunenori Kondo, Yasunobu Hashimoto, Hirohito Kobayashi, Junpei Iizuka, Eri Tomita, Toshio Takagi, and Kazunari Tanabe Tsunenori KondoTsunenori Kondo Tokyo, Japan More articles by this author , Yasunobu HashimotoYasunobu Hashimoto Tokyo, Japan More articles by this author , Hirohito KobayashiHirohito Kobayashi Tokyo, Japan More articles by this author , Junpei IizukaJunpei Iizuka Tokyo, Japan More articles by this author , Eri TomitaEri Tomita Tokyo, Japan More articles by this author , Toshio TakagiToshio Takagi Tokyo, Japan More articles by this author , and Kazunari TanabeKazunari Tanabe Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.1124AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy (PN) has now become the standard procedure for the tumors of T1a renal cell carcinoma (RCC) and the alternative standard for those of T1b especially in patients without severe co-morbidity. In our department, PN has been performed as a standard procedure in the tumor of T1a in recent years, and now we have performed PN for more patients with T1b. In the present study, we analyzed the influence of tumor size on the use of PN and the incidence of complications in the RCC patients with normal contralateral kidneys. METHODS From January 2004 until August 2010, 470 patients with RCC with normal contralateral kidneys underwent surgery in our department. Of these, 261 underwent radical nephrectomy (RN) and 209 PN. The proportion of PN to RN was calculated by tumor size. The complication in PN was also examined by tumor size. RESULTS In the first 4 years (2004–2007), PN was performed in 29.5 % of the patients (71/241) as shown in the Table. The use of PN dramatically decreased when the tumor size exceeded 3cm. In contrast, PN was performed for more patients in the last 3 years (2008–2010) at 60% (138/229). The use of PN was 90% for tumors of 4.0cm or less. Sixty-seven percent of patients with tumors of 4.1∼5.0cm were still treated with PN. However, the use of PN decreased when the tumor size exceeded 5cm although more patients underwent PN in the recent years as shown in the Table. The complication rate was not influenced by the tumor size, and stable at 6 – 10%. Urinary leakage was found in only 1 patient. In our series, only 1 patient developed distant metastases, and no patients had intrarenal local recurrence. Table. The influence of the tumor size on the use of PN Years of surgery/Tumor size (cm) ∼2.0 2.1∼3.0 3.1∼4.0 4.1∼5.0 5.1∼6.0 6.1∼7.0 7.1∼ Total 2004∼2007 95% (20/21) 66% (31/47) 29% (10/35) 17% (7/42) 9% (2/23) 0% (0/17) 2% (1/56) 29% (71/241) 2008∼ 100% (26/26) 93% (52/56) 80% (28/35) 67% (24/36) 22% (4/18) 14% (2/14) 5% (2/44) 60% (138/229) complication rate after PN 2008∼ 11% 10% 7% 6% 0% 7% 0% 9% (13/138) CONCLUSIONS In the expert institute, the use of PN has been increasing for tumors of 4cm or more. The majority of patients with tumors of 5cm or less underwent PN when the contralateral kidney was likely to be normal. Since the complication rate did not differ by tumor size, the application of PN may be extended to more patients with tumors of 7cm or less, increased experience has shown. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 185Issue 4SApril 2011Page: e437 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information Tsunenori Kondo Tokyo, Japan More articles by this author Yasunobu Hashimoto Tokyo, Japan More articles by this author Hirohito Kobayashi Tokyo, Japan More articles by this author Junpei Iizuka Tokyo, Japan More articles by this author Eri Tomita Tokyo, Japan More articles by this author Toshio Takagi Tokyo, Japan More articles by this author Kazunari Tanabe Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...