J Urol Oncol.
2024 Jul;22(2):136-143. 10.22465/juo.244800360018.
Comparison of Outcomes Between Radical Nephrectomy and Partial Nephrectomy in Clinical T2 Renal Cell Carcinoma: A Retrospective Korean Renal Cell Carcinoma Cohort Study
- Chung Y
1 - Byun SS1,2
- Hong SK1,2
- Lee S1,2
- Jeong CW2,3
- Kang SH4
- Hong SH5
- Lee JY5
- Kim YJ6
- Chung J7
- Hwang EC8
- Kwon TG9
- Kim JK10
- Affiliations
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- 1Department of Urology, Seoul National University Bundang Hospital, Seongnam, Korea
- 2Department of Urology, Seoul National University College of Medicine, Seoul, Korea
- 3Department of Urology, Seoul National University Hospital, Seoul, Korea
- 4Department of Urology, Korea University Anam Hospital, Seoul, Korea
- 5Department of Urology, Seoul St. Mary’s Hospital, The Catholic University of Korea, Seoul, Korea
- 6Department of Urology, Chungbuk National University Hospital, Cheongju, Korea
- 7Department of Urology, National Cancer Center, Goyang, Korea
- 8Department of Urology, Chonnam National University Medical School, Gwangju, Korea
- 9Department of Urology, Kyungpook National University Chilgok Hospital, Daegu, Korea
- 10Department of Urology, Asan Medical Center, Seoul, Korea
- KMID: 2558210
- DOI: http://doi.org/10.22465/juo.244800360018
Abstract
- Purpose
We compared the surgical outcomes of radical nephrectomy (RN) and partial nephrectomy (PN) in adult patients with clinical T2 stage (cT2) renal cell carcinoma (RCC) by utilizing data from the Korean Renal Cell Carcinoma (KORCC) database.
Materials and Methods
We retrospectively analyzed adult patients with cT2 RCC from 8 tertiary hospitals who were registered in the KORCC between 2003 and 2023. Patients with a solitary kidney or bilateral tumors were excluded. The patient cohort was divided into RN and PN arms, and propensity score matching (PSM) was conducted with a 1:3 ratio. Perioperative and survival outcomes were compared between arms.
Results
After PSM, the PN and RN arms included 44 and 132 patients, respectively. No significant differences were observed in baseline characteristics, apart from laterality, following PSM. Regarding perioperative outcomes, complications of Clavien-Dindo classification grade III or higher (11.4%, p<0.001) and urological complications (9.1%, p=0.045) were more common in the PN arm than in the RN arm. Postoperative renal function was superior in the PN arm, whereas the incidence of de novo chronic kidney disease (CKD) at 6 months was higher among the recipients of RN (37.6%, p<0.001). Pathological examination indicated a higher pathological T stage in the RN arm. Overall, cancer-specific, and recurrence-free survival rates did not differ significantly between arms. Based on Cox regression analysis, the use of PN was not a significant predictor of recurrence-free survival (hazard ratio, 0.675; p=0.474).
Conclusions
In cT2 RCC, PN was associated with a lower incidence of de novo CKD than RN. No significant differences in survival outcomes were noted. PN may represent a viable alternative to RN for certain patients with cT2 RCC. Further research is warranted to explore the management of advanced RCC.
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