MP30-07 ONCOLOGIC OUTCOMES AFTER PARTIAL NEPHRECTOMY IN RENAL CELL CARCINOMAS SMALLER THAN 7 CM WITH PRESUMED RENAL SINUS FAT INVOLVEMENT ON PREOPERATIVE IMAGING

You have accessJournal of UrologyKidney Cancer: Evaluation/Staging II1 Apr 2014MP30-07 ONCOLOGIC OUTCOMES AFTER PARTIAL NEPHRECTOMY IN RENAL CELL CARCINOMAS SMALLER THAN 7 CM WITH PRESUMED RENAL SINUS FAT INVOLVEMENT ON PREOPERATIVE IMAGING Kyo Chul Koo, Young Deuk Choi, Koon Ho Rha, Woong Kyu Han, Kang Su Cho, and Won Sik Ham Kyo Chul KooKyo Chul Koo More articles by this author , Young Deuk ChoiYoung Deuk Choi More articles by this author , Koon Ho RhaKoon Ho Rha More articles by this author , Woong Kyu HanWoong Kyu Han More articles by this author , Kang Su ChoKang Su Cho More articles by this author , and Won Sik HamWon Sik Ham More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.815AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although partial nephrectomy (PN) represents the standard of care for renal tumors ≤7 cm, it remains equivocal to radical nephrectomy (RN) for a subset of tumors suspected to involve renal sinus fat (cT3a). We compared the oncologic outcomes of PN and RN for these tumors. METHODS Among 1,137 extirpative renal surgeries performed for renal tumors ≤7 cm from January 2005 to August 2012, 458 cases of solitary, enhancing, cT3a tumors were identified. Among them, 401 cases of non-metastatic renal cell carcinoma (RCC) were analyzed. Classification as cT3a included only renal sinus fat invasion because no tumors were suspected of perinephric fat involvement on preoperative imaging. To assess the outcome of PN, multivariate Cox proportional hazards regression models were used to evaluate predictors of recurrence-free survival (RFS) and cancer-specific survival (CSS). RESULTS During the median follow-up of 43.5 months, recurrence occurred in 7 (6.7%) of 104 PN cases and 25 (8.4%) of 297 RN cases. Six recurred PN cases had positive surgical margins (PSM) and one case without PSM had sarcomatoid differentiation. The two cohorts showed equal oncologic outcomes with respect to 5-year RFS (log-rank p=0.664) and CSS (log-rank p=0.658). Multivariate analyses revealed PSM, pathologic T stage, sarcomatoid differentiation, and type of surgery as significant predictors of recurrence. Older age, pathologic T stage, and sarcomatoid differentiation were significant predictors of cancer-specific mortality. CONCLUSIONS PN showed oncologic outcomes equivalent to those of RN for cT3a RCCs ≤7 cm. If clear surgical margins can be obtained, PN should be considered for these patients because of its additional benefit of renal function preservation. © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e316 Advertisement Copyright & Permissions© 2014Metrics Author Information Kyo Chul Koo More articles by this author Young Deuk Choi More articles by this author Koon Ho Rha More articles by this author Woong Kyu Han More articles by this author Kang Su Cho More articles by this author Won Sik Ham More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...