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. 2021 Mar;10(3):1170-1178.
doi: 10.21037/tau-20-1262.

A meta-analysis for comparison of partial nephrectomy vs. radical nephrectomy in patients with pT3a renal cell carcinoma

Hui Liu  1 , Qing-Fang Kong  2 , Jian Li  3 , Yu-Qing Wu  4 , Ke-Hao Pan  1 , Bin Xu  1 , Ya-Li Wang  1 , Ming Chen  1
Affiliations

A meta-analysis for comparison of partial nephrectomy vs. radical nephrectomy in patients with pT3a renal cell carcinoma

Hui Liu et al. Transl Androl Urol. 2021 Mar.

Abstract

Background: Kidney cancer is the most common malignant tumor of the kidney in adults. However, in terms of the treatment for pT3a renal cell carcinoma (RCC), whether partial nephrectomy (PN) can be selected is still controversial. This study was conducted to compare the efficacy of PN and radical nephrectomy (RN) in treatment for patients with pT3a RCC.

Methods: The relative English databases including PubMed and EMBASE were searched for studies comparing PN and RN for pT3a RCC between 2010 and 2020. Stata 13.0 software was used to compare the cancer-specific survival (CSS), overall survival (OS), cancer-specific mortality (CSM), relapse-free survival (RFS), complications and positive surgical margin.

Results: Nine articles were included with a total of 3,391 patients, of whom 2,113 received RN and 1,278 received PN. The results showed that there is no statistical difference in CSS, OS, CSM, RFS, complications and positive surgical margin between RN and PN. No heterogeneity was shown in study.

Conclusions: There were no differences in the CSS, OS, CSM, RFS, complications and positive surgical margin of the patients in RN and PN group. For pT3a RCC, RN did not provide a better survival benefit compared to PN. Considering PN can suppress the progression of tumor and reduce the risk of postoperative chronic renal insufficiency, we found PN is a good choice for pT3a RCC. However, further large-sample, studies are still needed in future.

Keywords: Radical nephrectomy (RN); meta-analysis; pT3a renal cell carcinoma (pT3a RCC); partial nephrectomy (PN); survival.

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Conflict of interest statement

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/tau-20-1262). The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Flowchart of study selection.
Figure 2
Figure 2
Forest plot of CSS rates between PN and RN. CSS, cancer-specific survival; RN, radical nephrectomy; PN, partial nephrectomy.
Figure 3
Figure 3
Forest plot of OS rates between PN and RN. OS, overall survival; RN, radical nephrectomy; PN, partial nephrectomy.
Figure 4
Figure 4
Forest plot of CSM rates between PN and RN. CSM, cancer-specific mortality; RN, radical nephrectomy; PN, partial nephrectomy.
Figure 5
Figure 5
Forest plot of RFS rates between PN and RN. RFS, relapse-free survival; RN, radical nephrectomy; PN, partial nephrectomy.
Figure 6
Figure 6
Forest plot of complication between PN and RN. RN, radical nephrectomy; PN, partial nephrectomy.
Figure 7
Figure 7
Forest plot of positive surgical margin between PN and RN. RN, radical nephrectomy; PN, partial nephrectomy.
Figure 8
Figure 8
Publication bias funnel chart of CSS. CSS, cancer-specific survival.
Figure 9
Figure 9
Publication bias funnel chart of OS. OS, overall survival.
Figure 10
Figure 10
Publication bias funnel chart of CSM. CSM, cancer-specific mortality.
Figure 11
Figure 11
Publication bias funnel chart of RFS. RFS, relapse-free survival.
Figure 12
Figure 12
Publication bias funnel chart of complication.
Figure 13
Figure 13
Publication bias funnel chart of positive surgical margin.
See this image and copyright information in PMC

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