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Multicenter Study
. 2018 Apr;199(4):921-926.
doi: 10.1016/j.juro.2017.10.027. Epub 2017 Oct 21.

Long-Term Renal Function Recovery following Radical Nephrectomy for Kidney Cancer: Results from a Multicenter Confirmatory Study

Emily C Zabor  1 , Helena Furberg  2 , Byron Lee  3 , Steven Campbell  3 , Brian R Lane  4 , R Houston Thompson  5 , Elvis Caraballo Antonio  3 , Sabrina L Noyes  4 , Harras Zaid  5 , Edgar A Jaimes  6 , Paul Russo  7
Affiliations
Multicenter Study

Long-Term Renal Function Recovery following Radical Nephrectomy for Kidney Cancer: Results from a Multicenter Confirmatory Study

Emily C Zabor et al. J Urol. 2018 Apr.

Abstract

Purpose: We sought to confirm the findings from a previous single institution study of 572 patients from Memorial Sloan Kettering Cancer Center in which we found that 49% of patients recovered to the preoperative estimated glomerular filtration rate within 2 years following radical nephrectomy for renal cell carcinoma.

Materials and methods: A multicenter retrospective study was performed in 1,928 patients using data contributed from 3 independent centers. The outcome of interest was postoperative recovery to the preoperative estimated glomerular filtration rate. Data were analyzed using cumulative incidence and competing risks regression with death from any cause treated as a competing event.

Results: This study demonstrated that 45% of patients had recovered to the preoperative estimated glomerular filtration rate by 2 years following radical nephrectomy. Furthermore, this study confirmed that recovery of renal function differed according to preoperative renal function such that patients with a lower preoperative estimated glomerular filtration rate had an increased chance of recovery. This study also suggested that larger tumor size and female gender were significantly associated with an increased chance of renal function recovery.

Conclusions: In this multicenter retrospective study we confirmed that in the long term a large proportion of patients recover to preoperative renal function following radical nephrectomy for kidney tumors. Recovery is more likely among those with a lower preoperative estimated glomerular filtration rate.

Keywords: carcinoma; creatinine; kidney; kidney function tests; nephrectomy; renal cell.

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Figures

Figure 1
Figure 1
Postoperative eGFR trajectories according to preoperative eGFR in (A) the current multi-center study population and (B) the original MSKCC study (dotted lines represent individual patient data whereas solid lines represent LOWESS)
Figure 2
Figure 2
Cumulative incidence of eGFR recovery according to preoperative eGFR (solid lines represent results from the current multi-center study data; dashed lines represent results from the previous study using MSKCC data). The p-value is from competing risks regression adjusted for study center.
See this image and copyright information in PMC

Comment in

  • Editorial Comment.
    Ogan K. Ogan K. J Urol. 2018 Apr;199(4):926. doi: 10.1016/j.juro.2017.10.059. Epub 2017 Dec 29. J Urol. 2018. PMID: 29289604 No abstract available.

References

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