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. 2022 Jul 26:12:916018.
doi: 10.3389/fonc.2022.916018. eCollection 2022.

Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis

Situ Xiong  1   2 , Ming Jiang  1   2 , Yi Jiang  2   3 , Bing Hu  1   2 , Ru Chen  1   2 , Zhijun Yao  1   2 , Wen Deng  1   2 , Xianwen Wan  4 , Xiaoqiang Liu  1 , Luyao Chen  1 , Bin Fu  1   2
Affiliations

Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis

Situ Xiong et al. Front Oncol. .

Abstract

Purpose: The study aimed to compare operative, functional, and oncological outcomes between partial nephrectomy (PN) and radical nephrectomy (RN) for entophytic renal tumors (ERTs) by propensity score matching (PSM) analysis.

Methods: A total of 228 patients with ERTs who underwent PN or RN between August 2014 and December 2021 were assessed. A PSM in a 1:1 ratio was conducted to balance the differences between groups. Perioperative characteristics, renal functional, and oncological outcomes were compared between groups. Univariate and multivariate logistic and Cox proportional hazard regression analyses were used to determine the predictors of functional and survival outcomes.

Results: After PSM, 136 cases were matched to the PN group (n = 68) and the RN group (n = 68). Patients who underwent RN had shorter OT, less EBL, and lower high-grade complications (all p <0.05) relative to those who underwent PN. However, better perseveration of renal function was observed in the PN group, which was reflected in 48-h postoperative AKI (44.1% vs. 70.6%, p = 0.002), 1-year postoperative 90% eGFR preservation (45.6% vs. 22.1%, p = 0.004), and new-onset CKD Stage ≥III at last follow-up (2.9% vs. 29.4%, p <0.001). RN was the independent factor of short-term (OR, 2.812; 95% CI, 1.369-5.778; p = 0.005) and long-term renal function decline (OR, 10.242; 95% CI, 2.175-48.240; p = 0.003). Furthermore, PN resulted in a better OS and similar PFS and CSS as compared to RN (p = 0.042, 0.15, and 0.21, respectively). RN (OR, 7.361; 95% CI, 1.143-47.423; p = 0.036) and pT3 stage (OR, 4.241; 95% CI, 1.079-16.664; p = 0.039) were independent predictors of overall mortality.

Conclusion: Among patients with ERTs, although the PN group showed a higher incidence of high-grade complications than RN, when technically feasible and with experienced surgeons, PN is recommended for better preservation of renal function, longer OS, and similar oncological outcomes.

Keywords: endophytic renal tumor; function outcomes; oncological outcomes; operative outcomes; partial nephrectomy; propensity score matching; radical nephrectomy.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart for inclusion of patients. PN, partial nephrectomy; RN, radical nephrectomy.
Figure 2
Figure 2
Postoperative eGFR trend of patients in PN group and RN group after propensity score matching. eGFR, estimated glomerular filtration rate; PN, partial nephrectomy; RN, radical nephrectomy. "***" means p<0.001; "ns" means not statistically significant.
Figure 3
Figure 3
Kaplan–Meier curves for overall survival (A, D), progress-free survival (B, E), cancer-specific survival (C, F) between the PN and RN groups before and after propensity score matching. PN, partial nephrectomy; RN, radical nephrectomy.
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References

    1. Perez-Ardavin J, Sanchez-Gonzalez JV, Martinez-Sarmiento M, Monserrat-Monfort García-Olaverri JJ, Boronat-Tormo J, F, et al. . Surgical Treatment of Completely Endophytic Renal Tumor: A Systematic Review. Curr Urol Rep (2019) 20:3. doi: 10.1007/s11934-019-0864-x - DOI - PubMed
    1. Minoda R, Takagi T, Yoshida K, Kondo T, Tanabe K. Comparison of Surgical Outcomes Between Enucleation and Standard Resection in Robot-Assisted Partial Nephrectomy for Completely Endophytic Renal Tumors Through a 1:1 Propensity Score-Matched Analysis. J Endourol (2021) 35:1779–84. doi: 10.1089/end.2021.0213 - DOI - PubMed
    1. Kutikov A, Uzzo RG. The R.E.N.A.L. Nephrometry Score: A Comprehensive Standardized System for Quantitating Renal Tumor Size, Location and Depth. J Urol (2009) 182:844–53. doi: 10.1016/j.juro.2009.05.035 - DOI - PubMed
    1. Ljungberg B, Albiges L, Abu-Ghanem Y, Bensalah K, Dabestani S, Fernández-Pello S, et al. . European Association of Urology Guidelines on Renal Cell Carcinoma: The 2019 Update. Eur Urol (2019) 75:799–810. doi: 10.1016/j.eururo.2019.02.011 - DOI - PubMed
    1. Pierorazio PM, Johnson MH, Patel HD, Sozio SM, Sharma R, Iyoha E, et al. . Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-Analysis. J Urol (2016) 196:989–99. doi: 10.1016/j.juro.2016.04.081 - DOI - PMC - PubMed