Cancer Res Treat.  2016 Jan;48(1):288-296. 10.4143/crt.2014.297.

A Study of Relationship of Atheroembolic Risk Factors with Postoperative Recovery in Renal Function after Partial Nephrectomy in Patients Staged T1-2 Renal Cell Carcinoma during Median 4-Year Follow-up

Affiliations
  • 1Department of Urology, National Cancer Center, Goyang, Korea.
  • 2Biometric Research Branch, National Cancer Center, Goyang, Korea.
  • 3Department of Urology, Seoul National University Hospital, Seoul, Korea. eslee@snu.ac.kr
  • 4Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea.

Abstract

PURPOSE
The objective of this study is to evaluate the relationship of atheroembolic risk factors with postoperative recovery of renal function after on-clamp partial nephrectomy (PN) with warm ischemia in patients with staged T1-2 renal cell carcinoma (RCC).
MATERIALS AND METHODS
A total of 234 patients from 2004 to 2012 were included, and their clinicopathologic and operative parameters, including atheroembolic risk factors were reviewed retrospectively. Renal function, as determined by estimated glomerular filtration rate (eGFR) and measurement of serum creatinine level (Cr) at each scheduled follow-up for a median four years, was compared between the high-risk (HR) group (n=49, > or = five risk factors) and the low-risk (LR) group (n=185, < five risk factors).
RESULTS
Except for baseline renal function and number of risk factors for atheroembolism, differences in characteristics between groups were comparatively insignificant. At 3 months after the operation, Cr and eGFR differed significantly between the two groups (p < 0.05), but no differences were observed afterward. Significant deterioration from baseline in Cr and eGFR was observed in both groups at 1 month after the operation, with a greater change in the HR group (p < 0.05). From measurement to measurement, significantly faster deterioration in Cr and eGFR was observed in the HR group than in the LR group until 6 months after the operation (Cr: LR, 0.02 mg/dL and HR, 0.13 mg/dL; eGFR: LR, 1.50 mL/min/1.73 m2 and HR, 6.38 mL/min/1.73 m2; p < 0.05).
CONCLUSION
The presence of atheroembolic risk factors may negatively influence postoperative recovery of renal function after PN in patients with localized RCC.

Keyword

Renal cell carcinoma; Atherosclerosis; Embolism; Nephron sparing surgery; Renal function; Creatinine

MeSH Terms

Atherosclerosis
Carcinoma, Renal Cell*
Creatinine
Embolism
Embolism, Cholesterol
Follow-Up Studies*
Glomerular Filtration Rate
Humans
Nephrectomy*
Retrospective Studies
Risk Factors*
Warm Ischemia
Creatinine
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