The use of partial nephrectomy: results from a contemporary national prospective multicenter study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-01

AUTHORS

Géraldine Pignot, Arnaud Méjean, Jean-Christophe Bernhard, Pierre Bigot, Marc-Olivier Timsit, Jean-Marie Ferriere, Marc Zerbib, Arnauld Villers, Pascal Mouracade, Hervé Lang, Karim Bensalah, Jean-Philippe Couapel, Jerome Rigaud, Laurent Salomon, Laurent Bellec, Michel Soulié, Christophe Vaessen, Morgan Roupret, Hervé Baumert, Pierre Gimel, Jean-Jacques Patard, the CCAFU members

ABSTRACT

PURPOSE: Despite benefits in functional renal outcome and favorable oncological efficacy, previous studies show marked underuse of partial nephrectomy (PN). We investigated national utilization of partial and radical nephrectomy (RN) using a contemporary, prospective population-based cohort. METHODS: Between June and December 2010, 1,237 patients were treated by PN or RN for renal cell carcinoma in 56 French centers. Data were prospectively collected, and statistical analyses were performed. RESULTS: Overall, 667 (53.9 %) and 570 patients (46.1 %) underwent RN and PN, respectively. In case of PN, surgical approach was an open PN in 63.3 % of cases, a laparoscopic PN in 21.0 % of cases and a robot-assisted PN in 15.7 % of cases. PN was used in T1a, T1b, T2 and T3 tumors in 395 (76.7 %), 131 (38.2 %), 29 (14.7 %) and 7 (4.6 %), respectively. Median ischemia time was 16 min [0-60], and mean blood loss was 280.4 ml (±339.9). Tumor characteristics and operative features were significantly different according to the surgical approach. Warm ischemia time was significantly higher in case of laparoscopic or robot-assisted procedure (p < 0.001). There was no statistical significant difference in blood loss and transfusion rate according to surgical approach. Postoperative medical and surgical complications occurred in 8.2 and 10.0 % of PN, respectively, with no significant difference according to surgical approach. CONCLUSIONS: Partial nephrectomy for renal cell carcinoma is commonly used in this French centers sample. Mini-invasive approaches represent also a significant part of all partial nephrectomies with no difference in terms of complication rates. More... »

PAGES

33-40

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00345-014-1279-4

DOI

http://dx.doi.org/10.1007/s00345-014-1279-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046087221

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/24663965


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