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Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate
BACKGROUND: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). METHODS: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients w...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Academy of Medical Sciences
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193884/ https://www.ncbi.nlm.nih.gov/pubmed/30344463 http://dx.doi.org/10.3346/jkms.2018.33.e277 |
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author | Chung, Jae-Seung Son, Nak Hoon Lee, Sang Eun Hong, Sung Kyu Jeong, Chang Wook Kwak, Cheol Kim, Hyeon Hoe Hong, Sung Hoo Kim, Yong June Kang, Seok Ho Chung, Jinsoo Kwon, Tae Gyun Hwang, Eu Chang Byun, Seok-Soo |
author_facet | Chung, Jae-Seung Son, Nak Hoon Lee, Sang Eun Hong, Sung Kyu Jeong, Chang Wook Kwak, Cheol Kim, Hyeon Hoe Hong, Sung Hoo Kim, Yong June Kang, Seok Ho Chung, Jinsoo Kwon, Tae Gyun Hwang, Eu Chang Byun, Seok-Soo |
author_sort | Chung, Jae-Seung |
collection | PubMed |
description | BACKGROUND: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). METHODS: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I–II and stage III. Kidney function, and survival outcomes were compared between groups. RESULTS: We included 1,756 patients with CKD I–II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I–II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I–II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122–0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086–1.172; P = 0.117). CONCLUSION: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III. |
format | Online Article Text |
id | pubmed-6193884 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | The Korean Academy of Medical Sciences |
record_format | MEDLINE/PubMed |
spelling | pubmed-61938842018-10-22 Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate Chung, Jae-Seung Son, Nak Hoon Lee, Sang Eun Hong, Sung Kyu Jeong, Chang Wook Kwak, Cheol Kim, Hyeon Hoe Hong, Sung Hoo Kim, Yong June Kang, Seok Ho Chung, Jinsoo Kwon, Tae Gyun Hwang, Eu Chang Byun, Seok-Soo J Korean Med Sci Original Article BACKGROUND: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). METHODS: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I–II and stage III. Kidney function, and survival outcomes were compared between groups. RESULTS: We included 1,756 patients with CKD I–II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I–II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I–II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122–0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086–1.172; P = 0.117). CONCLUSION: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III. The Korean Academy of Medical Sciences 2018-10-01 /pmc/articles/PMC6193884/ /pubmed/30344463 http://dx.doi.org/10.3346/jkms.2018.33.e277 Text en © 2018 The Korean Academy of Medical Sciences. https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Chung, Jae-Seung Son, Nak Hoon Lee, Sang Eun Hong, Sung Kyu Jeong, Chang Wook Kwak, Cheol Kim, Hyeon Hoe Hong, Sung Hoo Kim, Yong June Kang, Seok Ho Chung, Jinsoo Kwon, Tae Gyun Hwang, Eu Chang Byun, Seok-Soo Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate |
title | Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate |
title_full | Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate |
title_fullStr | Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate |
title_full_unstemmed | Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate |
title_short | Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate |
title_sort | partial versus radical nephrectomy for t1-t2 renal cell carcinoma in patients with chronic kidney disease stage iii: a multiinstitutional analysis of kidney function and survival rate |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193884/ https://www.ncbi.nlm.nih.gov/pubmed/30344463 http://dx.doi.org/10.3346/jkms.2018.33.e277 |
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