Comparison of Radical and Partial Nephrectomy in Terms of Oncological and Functional Results

Özet

Introduction: This study is an evaluation of the oncological and functional outcomes of radical nephrectomy (RN) and partial nephrectomy (PN). Methods: A total of 201 patients with a kidney tumor who underwent RN and PN between January 2009 and July 2016 at the hospital were included in the study. Preoperative, operative, and postoperative follow-up data were recorded prospectively and analyzed retrospectively using the Student’s t-test and the Wilcoxon signed-rank test. Patient survival was analyzed using the Kaplan-Meier estimator. Results: In all, 79 patients underwent RN and 122 patients underwent PN. In the RN group, open surgery was performed for 38 patients, laparoscopic surgery for 32, and robotic surgery for 9 patients. In the PN group, open surgery was performed for 41, laparoscopic surgery for 10, and robotic surgery for 71 patients. The mean age of the RN and PN groups was 60.5 years and 55.4 years, respectively (p=0.007). The mean operation time was 207.1±51.3 minutes in the RN group and 193.1±56.5 minutes in the PN group (p=0.078). The mean estimated blood loss was 613.4±280.6 mL in the RN group and 274.2±258.6 mL in the PN group (p=0.005). The length of hospital stay was statistically significantly longer in the RN group (p<0.0001). The preoperative mean estimated glomerular filtration rate value of the RN and PN groups was 92.9±29.1 mL/min/1.73m2 and 108.8±31.8 mL/min/1.73m2, respectively, and decreased to 72.6±25 mL/min/1.73m2 and 101.2±32.7 mL/min/1.73m2, respectively, at postoperative month 6 (p<0.0001). The overall survival rate of the RN and PN groups was 69% and 86%, respectively, at postoperative month 80 (95% confidence interval). Discussion and Conclusion: PN is a viable option for tumors that are suitable for nephron-sparing surgery and has comparable functional and oncological results compared with RN.