Cancer - Kidney(구연) (E-086)

Paritial nephrectomy or radical nephrectomy in elderly patients over 75 years old
¹경북대학교 의과대학 비뇨의학과 교실
²경북대학교 병원 비뇨의학과
³칠곡 경북대학교 병원 비뇨의학과
이승윤², 권순오², 민경찬², 김현태¹², 김태환¹³, 권태균¹³, 최석환¹²
Introduction: Partial nephrectomy (PN) is preferred over radical nephrectomy (RN) in T1a localized renal tumors. But advantages of PN in elderly patients are not well investigated. Current study was to determine whether PN or RN in T1a stage offers different clinical outcomes in patients 75 years and older.

Methods: 73 Patients who underwent PN or RN from 2011 to 2019 were included in this study in retrospective manner. Clinico-pathologic data and peri-operative outcomes were compared, and renal function outcome was measured as change in serum creatinine and eGFR. Cox regression model was used to find out the variables affecting recurrence rate between two groups.

Results: Among 73 patients of T1a grade, 28 patients underwent PN and 65 patients underwent RN. Median follow-up was 41 months. There was no definite statically significant differences between two groups except tumor size and RENAL score (p<0.001 and p<0.001, respectively). Changes of eGFR in post operative day 5 was greater in RN group (P<0.001) but there was no statistically significant differences of changes in eGFR in the long term follow up. Post operative complications and recurrence rates were not significantly different in two groups, and surgical modality did not give superiority in terms of recurrence and renal function savings. Furhrman grade was the only risk factor affecting recurrence rate.


Conclusions: PN has been known for nephron saving surgery especially for T1a patients. However, in our study, surgical modality did not give any benefits in renal function saving as well as recurrence rate.
keywords : Radical nephrectomy, Partial nephrectomy, Localized renal cell carcinoma

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