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Long CJ , Canter DJ , Kutikov A , Li TY , Simhan J , Smaldone M , Teper E , Viterbo R , Boorjian SA , Chen DYT , Greenberg RE , Uzzo RG
Partial nephrectomy for renal masses >= 7 cm: technical, oncological and functional outcomes
Bju International. 2012 May;109(10) :1450-1456
PMID: WOS:000303118400008   
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OBJECTIVE To present outcomes for patients with renal masses >= 7 cm in size who are treated with partial nephrectomy (PN) at our institution and to summarize the cumulative published experience. PATIENTS AND METHODS We reviewed our prospectively maintained institutional kidney cancer database and identified patients undergoing PN for tumours >7 cm in size. Technical, oncological and renal functional data were analyzed and compared with the existing published experience of PNs for tumours >7 cm in size. RESULTS In total, 46 patients with 49 renal tumours >7 cm in size who underwent PN were identified. With a median (range) follow-up of 13.1 (0.2-170.0) months, there were 16 complications, including four (8.2%) blood transfusions and six (12.2%) urinary fistulae. The 5- and 10-year overall and renal cell carcinoma (RCC)-specific survivals were 94.5% and 70.9%. There were five (10.9%) patients who had an upward migration in their chronic kidney disease status after PN. There were six previous series totalling 280 tumours encompassing the published experience of PN for tumours >7 cm in size. The incidence of urinary fistulae and postoperative haemorrhage, respectively, was in the range 3.3-18.8% and 0-3%. Although oncological outcomes showed cancer-specific survival in the range 66-97.0%, series matching PN and RN in patients with T2 RCC show equivalency in RCC-specific and overall survivals. When reported, PN for tumours >7 cm in size was associated with better renal functional preservation. CONCLUSION The findings of the present study show that PN can safely be performed in tumours >= 7 cm in size with acceptable technical, oncological and functional outcomes. Further studies are warranted.
Long, Christopher J. Canter, Daniel J. Kutikov, Alexander Li, Tianyu Simhan, Jay Smaldone, Marc Teper, Ervin Viterbo, Rosalia Boorjian, Stephen A. Chen, David Y. T. Greenberg, Richard E. Uzzo, Robert G. National Cancer Institute[P30 CA006927]; Fox Chase Cancer This publication was supported in party by grant number P30 CA006927 from the National Cancer Institute. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health. Additional funds were provided by Fox Chase Cancer via institutional support of the Kidney Cancer Keystone Program. 30 Wiley-blackwell Malden 930dw