You have accessJournal of UrologyKidney Cancer: Surgical Therapy II1 Apr 2015MP57-17 COMPARISON OF SURVIVAL RATES IN STAGE ONE RENAL CELL CARCINOMA BETWEEN PARTIAL NEPHRECTOMY AND RADICAL NEPHRECTOMY PATIENTS ACCORDING TO AGE DISTRIBUTION Toshio Takagi, Tsunenori Kondo, Kenji Omae, Junpei Iizuka, Hirohito Kobayashi, Yasunobu Hashimoto, and Kazunari Tanabe Toshio TakagiToshio Takagi More articles by this author , Tsunenori KondoTsunenori Kondo More articles by this author , Kenji OmaeKenji Omae More articles by this author , Junpei IizukaJunpei Iizuka More articles by this author , Hirohito KobayashiHirohito Kobayashi More articles by this author , Yasunobu HashimotoYasunobu Hashimoto More articles by this author , and Kazunari TanabeKazunari Tanabe More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.2005AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Patients undergoing PN had lower rates of cardiovascular events and better survival rates than those with radical nephrectomy (RN) in previous retrospective study. However, a randomized study (EORTC 30904) could not demonstrate the superiority of PN over RN in either survival rates or kidney function. Although that study has some limitations, we should discuss what type of patients with small renal tumors are likely to benefit more from PN than from RN. Thus, we compared the effects of PN and RN on overall survival in patients with localized renal cell carcinoma (RCC) according to age and analyzed what age groups benefit most from PN. METHODS This study comprises 989 patients with Stage 1 RCC who underwent PN or RN at Tokyo Women's Medical University Hospital. Patients are divided into three groups according to age: Group 1(≤ 54 years), Group 2(55-64) and Group 3(≥65). We compared overall survival(OS), patient characteristics including the presence of hypertension(HT), diabetes mellitus(DM), and preoperative eGFR between PN and RN among the three groups. RESULTS Group 1 included 340 patients(PN: 205, RN:123); Group 2, 318(PN:201, RN 117); and Group 3, 331(PN:209, RN:122). Older groups have significantly lower preoperative eGFR values and higher rates of HT and DM(all p<0.0001). However, these characteristics are similar between PN and RN in each group. In addition, PN can preserve more renal function than RN in all groups, despite a bit worse preoperative eGFR in the PN group than in RN. In Group 2 and Group 3, there is a significant difference in OS between PN and RN(Group2 5-yr PN: 98% RN: 89% p=0.0125, Group3 PN: 91% RN: 82% p=0.0098), whereas, a significant difference is not seen in Group 1(PN: 100% RN: 96% p=0.182). CONCLUSIONS Our study demonstrated that PN has significantly better survival rates than RN in older patients, but not in younger ones, suggesting that patients with comorbidities may receive more benefit from PN than those without. We propose that patients should not avoid PN only because of their advanced age. We also recommend PN for young patients with T1 RCC despite no significant overall survival difference between surgical approaches because of the other, important benefits it offers, including avoiding treatment for benign tumors and keeping other options open. Group 1 (n=340) Group 2 (n=318) Group 3 (n=331) p Age (year), mean, IQR 45 (40-51) 60 (57-62) 72 (67-76) <0.0001 BMI (kg/m2), mean (IQR) 24 (22-26) 24 (22-26) 24(22-26) 0.4334 Gender, male, n (%) 253 (74) 232 (73) 229 (69) 0.3008 HT, n (%) 50 (15) 133 (42) 166 (50) <0.0001 DM, n (%) 20 (6) 60 (19) 81 (25) <0.0001 Preop eGFR, mean(IQR) 81 (69-91) 70 (59-81) 62 (50-73) <0.0001 Postop eGFR, mean(IQR) 67 (54-79) 56 (45-67) 50 (37-62) <0.0001 Tumor size (cm), mean, IQR 3.5 (2.4-4.5) 3.5 (2.3-4.6) 3.3 (2.3-4.2) 0.1306 Follow up (month), mean (IQR) 78 (24-111) 62 (20-81) 51 (21-67) 0.0002 © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e696 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Toshio Takagi More articles by this author Tsunenori Kondo More articles by this author Kenji Omae More articles by this author Junpei Iizuka More articles by this author Hirohito Kobayashi More articles by this author Yasunobu Hashimoto More articles by this author Kazunari Tanabe More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...