Nephron-sparing surgery of renal cell carcinoma with a normal opposite kidney: long-term outcome in 180 patients
Objectives. To investigate the long-term outcome of an organ-saving approach for renal cell carcinoma (RCC) with a normal opposite kidney (elective indication). Methods. Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralater...
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| Veröffentlicht in: | Urology (Ridgewood, N.J.) N.J.), 2000-09, Vol.56 (3), p.387-392 |
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| container_title | Urology (Ridgewood, N.J.) |
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| creator | Filipas, Dragana Fichtner, Jan Spix, Claudia Black, Peter Carus, Wolfgang Hohenfellner, Rudolf Thüroff, Joachim W |
| description | Objectives. To investigate the long-term outcome of an organ-saving approach for renal cell carcinoma (RCC) with a normal opposite kidney (elective indication).
Methods. Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralateral kidney. The mean age was 56 years (range 23 to 83), and the mean follow-up was 4.7 years (maximum 14.8). Most of these tumors were found incidentally, with a mean tumor diameter on ultrasound of 3.3 cm (range 1.0 to 8.6).
Results. The postoperative course was unremarkable in 173 patients. Postoperative bleeding was encountered in 4 patients and urinary extravasation in an additional 3 patients. No surgical reintervention was necessary. One hundred seventy-five RCCs were pT1 and 5 were pT3a; 73 were grade 1, 100 grade 2, and 7 were grade 3. The mean tumor diameter (surgical specimen) was 3.2 cm (range 0.5 to 7). In 132 cases, the tumor was less than 4 cm and in 48 cases, greater than 4 cm. Three patients experienced local tumor recurrence (1.6%) during follow-up, and two others developed distant metastases. The 5-year tumor-specific survival rate was 98.0%.
Conclusions. Nephron-sparing surgery for RCC under an elective indication in selected patients offers excellent long-term survival and an acceptably low local tumor recurrence rate. These results support the concept of nephron-sparing surgery in the presence of a normal contralateral kidney. |
| doi_str_mv | 10.1016/S0090-4295(00)00656-7 |
| format | Article |
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Methods. Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralateral kidney. The mean age was 56 years (range 23 to 83), and the mean follow-up was 4.7 years (maximum 14.8). Most of these tumors were found incidentally, with a mean tumor diameter on ultrasound of 3.3 cm (range 1.0 to 8.6).
Results. The postoperative course was unremarkable in 173 patients. Postoperative bleeding was encountered in 4 patients and urinary extravasation in an additional 3 patients. No surgical reintervention was necessary. One hundred seventy-five RCCs were pT1 and 5 were pT3a; 73 were grade 1, 100 grade 2, and 7 were grade 3. The mean tumor diameter (surgical specimen) was 3.2 cm (range 0.5 to 7). In 132 cases, the tumor was less than 4 cm and in 48 cases, greater than 4 cm. Three patients experienced local tumor recurrence (1.6%) during follow-up, and two others developed distant metastases. The 5-year tumor-specific survival rate was 98.0%.
Conclusions. Nephron-sparing surgery for RCC under an elective indication in selected patients offers excellent long-term survival and an acceptably low local tumor recurrence rate. These results support the concept of nephron-sparing surgery in the presence of a normal contralateral kidney.</description><identifier>ISSN: 0090-4295</identifier><identifier>EISSN: 1527-9995</identifier><identifier>DOI: 10.1016/S0090-4295(00)00656-7</identifier><identifier>PMID: 10962300</identifier><identifier>CODEN: URGYAZ</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; Carcinoma, Renal Cell - mortality ; Carcinoma, Renal Cell - pathology ; Carcinoma, Renal Cell - surgery ; Female ; Follow-Up Studies ; Humans ; Kidney Neoplasms - mortality ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Male ; Medical sciences ; Middle Aged ; Nephrectomy - methods ; Postoperative Complications ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the urinary system ; Survival Rate ; Treatment Outcome</subject><ispartof>Urology (Ridgewood, N.J.), 2000-09, Vol.56 (3), p.387-392</ispartof><rights>2000 Elsevier Science Inc.</rights><rights>2000 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c390t-d7998649235c112386dfcf3ec415a4271348813bfb7376eae7bced88390d7b163</citedby><cites>FETCH-LOGICAL-c390t-d7998649235c112386dfcf3ec415a4271348813bfb7376eae7bced88390d7b163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0090-4295(00)00656-7$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27929,27930,46000</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1470272$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10962300$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Filipas, Dragana</creatorcontrib><creatorcontrib>Fichtner, Jan</creatorcontrib><creatorcontrib>Spix, Claudia</creatorcontrib><creatorcontrib>Black, Peter</creatorcontrib><creatorcontrib>Carus, Wolfgang</creatorcontrib><creatorcontrib>Hohenfellner, Rudolf</creatorcontrib><creatorcontrib>Thüroff, Joachim W</creatorcontrib><title>Nephron-sparing surgery of renal cell carcinoma with a normal opposite kidney: long-term outcome in 180 patients</title><title>Urology (Ridgewood, N.J.)</title><addtitle>Urology</addtitle><description>Objectives. To investigate the long-term outcome of an organ-saving approach for renal cell carcinoma (RCC) with a normal opposite kidney (elective indication).
Methods. Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralateral kidney. The mean age was 56 years (range 23 to 83), and the mean follow-up was 4.7 years (maximum 14.8). Most of these tumors were found incidentally, with a mean tumor diameter on ultrasound of 3.3 cm (range 1.0 to 8.6).
Results. The postoperative course was unremarkable in 173 patients. Postoperative bleeding was encountered in 4 patients and urinary extravasation in an additional 3 patients. No surgical reintervention was necessary. One hundred seventy-five RCCs were pT1 and 5 were pT3a; 73 were grade 1, 100 grade 2, and 7 were grade 3. The mean tumor diameter (surgical specimen) was 3.2 cm (range 0.5 to 7). In 132 cases, the tumor was less than 4 cm and in 48 cases, greater than 4 cm. Three patients experienced local tumor recurrence (1.6%) during follow-up, and two others developed distant metastases. The 5-year tumor-specific survival rate was 98.0%.
Conclusions. Nephron-sparing surgery for RCC under an elective indication in selected patients offers excellent long-term survival and an acceptably low local tumor recurrence rate. These results support the concept of nephron-sparing surgery in the presence of a normal contralateral kidney.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Carcinoma, Renal Cell - mortality</subject><subject>Carcinoma, Renal Cell - pathology</subject><subject>Carcinoma, Renal Cell - surgery</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Kidney Neoplasms - mortality</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - surgery</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Nephrectomy - methods</subject><subject>Postoperative Complications</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the urinary system</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0090-4295</issn><issn>1527-9995</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1v1DAQhi0EotvCTwD5gFA5pIztxI65IFTxJVVwAM6W40y2hsQOdlK0_77e7qpw4zI-zPPOeB5CnjG4YMDk628AGqqa6-Yc4BWAbGSlHpANa7iqtNbNQ7K5R07Iac4_oVBSqsfkhIGWXABsyPwF5-sUQ5Vnm3zY0rymLaYdjQNNGOxIHY6l2OR8iJOlf_xyTS0NMU2lGec5Zr8g_eX7gLs3dIxhWy2YJhrXxcUJqQ-UtUBnu3gMS35CHg12zPj0-J6RHx_ef7_8VF19_fj58t1V5YSGpeqV1q2sNReNY4yLVvaDGwS6mjW25oqJum2Z6IZOCSXRouoc9m1bwr3qmBRn5OVh7pzi7xXzYiaf97fYgHHNRnHO2lqKAjYH0KWYc8LBzMlPNu0MA7NXbe5Um71HA2DuVBtVcs-PC9Zuwv6f1MFtAV4cAZudHYdkg_P5L1cr4IoX7O0Bw2LjxmMy2RVT5Rqf0C2mj_4_P7kFxFma0w</recordid><startdate>20000901</startdate><enddate>20000901</enddate><creator>Filipas, Dragana</creator><creator>Fichtner, Jan</creator><creator>Spix, Claudia</creator><creator>Black, Peter</creator><creator>Carus, Wolfgang</creator><creator>Hohenfellner, Rudolf</creator><creator>Thüroff, Joachim W</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20000901</creationdate><title>Nephron-sparing surgery of renal cell carcinoma with a normal opposite kidney: long-term outcome in 180 patients</title><author>Filipas, Dragana ; Fichtner, Jan ; Spix, Claudia ; Black, Peter ; Carus, Wolfgang ; Hohenfellner, Rudolf ; Thüroff, Joachim W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c390t-d7998649235c112386dfcf3ec415a4271348813bfb7376eae7bced88390d7b163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Carcinoma, Renal Cell - mortality</topic><topic>Carcinoma, Renal Cell - pathology</topic><topic>Carcinoma, Renal Cell - surgery</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Humans</topic><topic>Kidney Neoplasms - mortality</topic><topic>Kidney Neoplasms - pathology</topic><topic>Kidney Neoplasms - surgery</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Nephrectomy - methods</topic><topic>Postoperative Complications</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the urinary system</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Filipas, Dragana</creatorcontrib><creatorcontrib>Fichtner, Jan</creatorcontrib><creatorcontrib>Spix, Claudia</creatorcontrib><creatorcontrib>Black, Peter</creatorcontrib><creatorcontrib>Carus, Wolfgang</creatorcontrib><creatorcontrib>Hohenfellner, Rudolf</creatorcontrib><creatorcontrib>Thüroff, Joachim W</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Urology (Ridgewood, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Filipas, Dragana</au><au>Fichtner, Jan</au><au>Spix, Claudia</au><au>Black, Peter</au><au>Carus, Wolfgang</au><au>Hohenfellner, Rudolf</au><au>Thüroff, Joachim W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Nephron-sparing surgery of renal cell carcinoma with a normal opposite kidney: long-term outcome in 180 patients</atitle><jtitle>Urology (Ridgewood, N.J.)</jtitle><addtitle>Urology</addtitle><date>2000-09-01</date><risdate>2000</risdate><volume>56</volume><issue>3</issue><spage>387</spage><epage>392</epage><pages>387-392</pages><issn>0090-4295</issn><eissn>1527-9995</eissn><coden>URGYAZ</coden><abstract>Objectives. To investigate the long-term outcome of an organ-saving approach for renal cell carcinoma (RCC) with a normal opposite kidney (elective indication).
Methods. Since 1979, 180 patients have undergone nephron-sparing surgery at our institution for RCC in the presence of a normal contralateral kidney. The mean age was 56 years (range 23 to 83), and the mean follow-up was 4.7 years (maximum 14.8). Most of these tumors were found incidentally, with a mean tumor diameter on ultrasound of 3.3 cm (range 1.0 to 8.6).
Results. The postoperative course was unremarkable in 173 patients. Postoperative bleeding was encountered in 4 patients and urinary extravasation in an additional 3 patients. No surgical reintervention was necessary. One hundred seventy-five RCCs were pT1 and 5 were pT3a; 73 were grade 1, 100 grade 2, and 7 were grade 3. The mean tumor diameter (surgical specimen) was 3.2 cm (range 0.5 to 7). In 132 cases, the tumor was less than 4 cm and in 48 cases, greater than 4 cm. Three patients experienced local tumor recurrence (1.6%) during follow-up, and two others developed distant metastases. The 5-year tumor-specific survival rate was 98.0%.
Conclusions. Nephron-sparing surgery for RCC under an elective indication in selected patients offers excellent long-term survival and an acceptably low local tumor recurrence rate. These results support the concept of nephron-sparing surgery in the presence of a normal contralateral kidney.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10962300</pmid><doi>10.1016/S0090-4295(00)00656-7</doi><tpages>6</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Biological and medical sciences Carcinoma, Renal Cell - mortality Carcinoma, Renal Cell - pathology Carcinoma, Renal Cell - surgery Female Follow-Up Studies Humans Kidney Neoplasms - mortality Kidney Neoplasms - pathology Kidney Neoplasms - surgery Male Medical sciences Middle Aged Nephrectomy - methods Postoperative Complications Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the urinary system Survival Rate Treatment Outcome |
| title | Nephron-sparing surgery of renal cell carcinoma with a normal opposite kidney: long-term outcome in 180 patients |
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