Impact of Nephron–Sparing Surgery on Quality of Life in Patients with Localized Renal Cell Carcinoma

Abstract

Objectives: The aim of the study is to evaluate the impact of nephron–sparing surgery on postoperative quality of life (QOL) in patients with localized renal cell carcinoma, compared with radical nephrectomy. Methods: From 1986 to 1996, a total of 66 patients with localized small renal cell carcinoma <4 cm in diameter and a functioning contralateral renal unit underwent radical nephrectomy (n = 51) or nephron–sparing surgery (n = 15). Of these, 50 patients evaluated various dimensions of QOL using standardized self–rating questionnaires, EORTC QLQ–C30. Results: There is no significant difference in 5–year overall survival between the nephron–sparing surgery group and the radical nephrectomy group. With regard to postoperative QOL, patients who underwent nephron–sparing surgery showed a significantly higher score on physical function than patients treated with radical nephrectomy (p<0.05). Nephron–sparing surgery was additionally superior to radical nephrectomy in terms of fatigue, sleep disturbance, pain and constipation. Conclusion: Selected patients with localized, small, unilateral renal cell carcinoma and a normal contralateral kidney will benefit from nephron–sparing surgery.