You have accessJournal of UrologyKidney Cancer: Localized V1 Apr 20121851 RENAL AND CARDIOVASCULAR MORBIDITY AFTER PARTIAL OR RADICAL NEPHRECTOMY IN PATIENTS WITH KIDNEY TUMORS UP TO 7 CENTIMETERS: IMPLICATIONS ON OVERALL MORTALITY Marco Roscigno, Richard Naspro, Francesca Ceresoli, Ettore Di Trapani, Rayan Matloob, Cristina Carenzi, Gianfranco Deiana, Umberto Capitanio, Patrizio Rigatti, Francesco Montorsi, Luigi F. Da Pozzo, and Roberto Bertini Marco RoscignoMarco Roscigno Bergamo, Italy More articles by this author , Richard NasproRichard Naspro Bergamo, Italy More articles by this author , Francesca CeresoliFrancesca Ceresoli Bergamo, Italy More articles by this author , Ettore Di TrapaniEttore Di Trapani Milan, Italy More articles by this author , Rayan MatloobRayan Matloob Milan, Italy More articles by this author , Cristina CarenziCristina Carenzi Milan, Italy More articles by this author , Gianfranco DeianaGianfranco Deiana Bergamo, Italy More articles by this author , Umberto CapitanioUmberto Capitanio Milan, Italy More articles by this author , Patrizio RigattiPatrizio Rigatti Milan, Italy More articles by this author , Francesco MontorsiFrancesco Montorsi Milan, Italy More articles by this author , Luigi F. Da PozzoLuigi F. Da Pozzo Bergamo, Italy More articles by this author , and Roberto BertiniRoberto Bertini Milan, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.1961AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate the impact of radical nephrectomy (RN) or partial nephrectomy (PN) on estimated Glomerular Filtration Rate (eGFR) and cardiovascular morbidity, and whether it could affect overall mortality (OM) in patients treated for renal cell carcinoma (RCC) of up to 7 cm. METHODS From 1987 to 2007, 930 consecutive patients underwent surgery at our institution for sporadic RCC of up to 7 cm of diameter, with a normal contralateral kidney. Renal Function was evaluated by the Estimated Glomerular Filtration Rate (eGFR) pre-operatively and at last folow-up. Renal function worsening was defined as a decrease of eGFR below 60 ml/min/1.73m2, or as a change of class in renal function. Age was coded as quartile (29-50 yrs; 51-60 yrs; 61-70 yrs and 71-89 yrs). Univariable and multivariable logistic regression analyses addressed the impact of performing RN vs PN on renal function worsening and on cardiovascular morbidity. Cox regression analyses addressed the role of nephron-sparing surgery on cancer-specific mortality (CSM) and OM. RESULTS RN was performed in 443 patients and PN in 487. Median follow-up was 61 months (range: 5-283 mos). Thirty-seven percent of patients who underwent RN had renal function worsening, compared to 16% of patients undergoing PN (p<0.001). At multivariable logistic regression analysis, PN (p<0,001), younger age (p<0.001) and absence of smoking history (p=0.047) were associated with a reduced risk of renal function impairment, after adjusting for Charlson Comorbidity Index, gender, presence of hypertension, preoperative eGFR. PN was also an independent predictor of reduced risk of cardiovascular morbidity (p < 0.001), after adjusting for the other confounders. The type of surgery did not achieve the independent predictor status of CSM or OM, after adjusting for pT, pN, presence of distant metastases, worsening of renal function and cardiovascular morbidity. Nonetheless, worsening of renal function and cardiovascular morbidity were independent predictors of OM (p = 0.07 and p = 0.08, respectively). CONCLUSIONS PN was significantly associated with a reduced risk of worsening of renal function and a reduced risk of cardiovascular morbidity. PN did not achieve the independent predictor status of OM. However, renal function worsening and cardiovascular morbidity, both influenced by the type of surgery, were associated with a higher risk of OM. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e748-e749 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Roscigno Bergamo, Italy More articles by this author Richard Naspro Bergamo, Italy More articles by this author Francesca Ceresoli Bergamo, Italy More articles by this author Ettore Di Trapani Milan, Italy More articles by this author Rayan Matloob Milan, Italy More articles by this author Cristina Carenzi Milan, Italy More articles by this author Gianfranco Deiana Bergamo, Italy More articles by this author Umberto Capitanio Milan, Italy More articles by this author Patrizio Rigatti Milan, Italy More articles by this author Francesco Montorsi Milan, Italy More articles by this author Luigi F. Da Pozzo Bergamo, Italy More articles by this author Roberto Bertini Milan, Italy More articles by this author Expand All Advertisement Advertisement PDF DownloadLoading ...