Management of high complexity renal masses in partial nephrectomy: A multicenter analysis.
Publication Title
Urologic oncology
Document Type
Article
Publication Date
7-1-2019
Keywords
Nephrometry; Partial Nephrectomy; RENAL score; Renal cell carcinoma; Trifecta
Abstract
OBJECTIVE: To determine the safety and efficacy of performing partial nephrectomy (PN) on patients with high nephrometry score tumors.
PATIENTS AND METHODS: We used a prospectively maintained multi-institutional kidney cancer database to identify 144 patients with R.E.N.A.L. nephrometry score ≥10 who underwent PN for a cT1-cT2 renal mass. Baseline demographics and clinical characteristics, tumor characteristics, perioperative, and pathological outcomes were analyzed and reported. Trifecta achievement, defined by warm ischemia time <25 >minutes, no perioperative complications, and negative surgical margins, was the primary outcome. We assessed the relationship of baseline clinical and tumor characteristics data to trifecta achievement and perioperative complications.
RESULTS: Baseline median eGFR was 84.57 ml/min/1.73 m
CONCLUSION: In treating complex renal tumors, PN should be performed when possible. Although this remains a challenging procedure, with experience and appropriate case selection, the trifecta outcome can be achieved in a significant number of patients with high renal score lesions.
Clinical Institute
Kidney & Diabetes
Specialty/Research Institute
Nephrology
Specialty/Research Institute
Urology
Specialty/Research Institute
Surgery
