Does The Type Of Nephrectomy Affect Oncologic Outcomes İn Pathological Stage pTt1 Renal Cell Carcinoma With High Fuhrman Grade?
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Original Article
VOLUME: 51 ISSUE: 3
P: 340 - 347
2018

Does The Type Of Nephrectomy Affect Oncologic Outcomes İn Pathological Stage pTt1 Renal Cell Carcinoma With High Fuhrman Grade?

Acta Haematol Oncol Turc 2018;51(3):340-347
1. Department of Urology, Karabük University Training and Research Hospital, Karabük, Turkey
2. Department of Urology, University of Health Sciences Dr. Abdurrahman Yurtaslan Ankara Oncology Training and Research Hospital, Ankara, Turkey
3.
No information available.
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Received Date: 2018-11-17T20:42:51
Accepted Date: 2018-12-28T09:10:04
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Abstract

INTRODUCTION

In clinical stage I renal cell carcinoma (RCC), partial nephrectomy (PN) is actual recommended surgical technique. However, poor pathological tumor features have more negative prognosis. We aimed to evaluate the effects of performing partial or radical nephrectomy(RN) on local recurrence, distant metastasis and cancer-specific survival in stage pT1 RCC with high Fuhrman grade.

METHODS

Data of patients who underwent PN or RN due to pathological stage pT1 RCC with high Fuhrman grade, between January 2009 and July 2016 were retrospectively evaluated. 66 of them whose datas were fully accessible, were included to study. Demographic datas, histological tumor types, Fuhrman grading, local recurrence, distant metastasis and survival rates after nephrectomy were recorded. The patients were divided into two groups as RN (Group I) and PN (Group II).

RESULTS

Mean age of patients was 57.67±10.23. Among them, 6(9.1%) patients had local recurrence, 8(12.1%) had distant metastasis and 8(12.1%) had cancer related death. Group II had higher local recurrence rate (11.1%, p=0.532), distant metastasis rate (18.9%, p=0.630), cancer-specific survival (94.16 months, p=0.560); lower predicted recurrence-free survival (89.46 months, p=0.433) and metastasis-free survival (84.94 months, p=0.617). But there were no significantly difference. In multivariate analysis, hypertension for local recurrence; Fuhrman grade 4, female gender, BMI>27 for distant metastasis, and estimated glomerular filtration rate<90 for cancer-specific survival were independent predictive factors.

DISCUSSION AND CONCLUSION

We found that PN or RN did not significantly alter the oncologic outcomes in follow-up of patients with high Fuhrman grade, stage pT1 RCC. For this reason, it is more appropriate to use nephron sparing technique.

Keywords:
High Fuhrman grade, oncologic outcomes, partial nephrectomy, renal cell carcinoma, T1 stage