Propensity-score matched comparison of partial versus radical nephrectomy for T1N0M0 sarcomatoid renal cell carcinoma

BACKGROUND: Sarcomatoid renal cell carcinoma is a rare variant of renal cell carcinoma associated with poor clinical outcomes. Currently no reliable evidence indicates whether partial nephrectomy can be an effective treatment for patients with T1N0M0 sarcomatoid renal cell carcinoma. The present study was conducted to compare the overall and cancer-specific survival with partial and radical nephrectomy for such cases. METHODS: Data of sarcomatoid renal cell carcinoma were retrieved from Surveillance, Epidemiology, and End Results database. Factors independently associated with the overall or cancer-specific survival were identified by Cox regression analysis. The overall and cancer-specific survival of propensity-score matched T1N0M0 sarcomatoid renal cell carcinoma patients treated by partial and radical nephrectomy were estimated by the Kaplan-Meier method. RESULTS: The records of 452 T1N0M0 sarcomatoid renal cell carcinoma cases were retrieved. One hundred and fifty-five of these patients underwent partial nephrectomy, while the remaining 297 underwent radical nephrectomy. The median follow-up period in partial-treated group was 38 months (ranging from 2 to 132 months), while that in RN-treated was 39 months (ranging from 0 to 150 months). Age, sex, marital status and tumor size were independent risk factors for the overall and cancer-specific survival. There were no significant differences among age, sex, marital status and tumor size in the PN- and RN-treated T1N0M0 cases according to propensity-score matching. The estimated median overall survival of partial-treated group was 132 months, while that for RN-treated cases was 100 months (P=0.11). The median cancer-specific survival was not reached in both groups (P=0.092). CONCLUSIONS: The overall and cancer-specific survival of T1N0M0 patients treated by partial nephrectomy was not inferior to that of patients treated by radical nephrectomy.