The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma

Amy Krambeck, Bradley C. Leibovich, Christine M. Lohse, Eugene D. Kwon, Horst Zincke, Michael L. Blute

Research output: Contribution to journalArticle

38 Citations (Scopus)

Abstract

Purpose: Studies have demonstrated increased time to progression when cytoreductive nephrectomy is performed for metastatic renal cell carcinoma. We evaluated the role of nephron sparing surgery in these patients. Materials and Methods: We selected all patients with pM1 renal cell carcinoma treated with nephron sparing surgery or radical nephrectomy, and all patients with pM0 renal cell carcinoma undergoing nephron sparing surgery for solitary kidney from 1970 to 2002 from the Mayo Clinic Nephrectomy Registry. Results: We identified 16 patients who underwent nephron sparing surgery for pM1 renal cell carcinoma. Solitary kidney was present in 12, 3 had bilateral synchronous disease and 1 had elective nephron sparing surgery. Cancer specific survival rates at 1, 3 and 5 years were 81%, 49% and 49%, respectively. We identified 404 patients who underwent radical nephrectomy for pM1 renal cell carcinoma. Cancer specific survival rates at 1, 3 and 5 years were 51%, 21% and 13%, respectively. The pM1 nephron sparing surgery for solitary kidney cases were more likely to have early (33% vs 10%, p = 0.009) or late (50% vs 19%, p = 0.018) complications compared with pM1 radical nephrectomy cases. There were no significant differences in early (p = 0.475) or late (p = 0.350) complications between pM1 nephron sparing surgery cases and 139 pM0 nephron sparing surgery cases. Conclusions: Cancer specific survival rates in pM1 nephron sparing surgery cases were comparable to pM1 radical nephrectomy cases. Although there were differences in early and late complications between the pM1 nephron sparing surgery and pM1 radical nephrectomy groups, there were no differences when compared with imperative pM0 nephron sparing surgery cases. This study demonstrates that nephron sparing surgery can achieve adequate cytoreductive therapy while preserving renal function, with postoperative complication rates similar to those of pM0 nephron sparing surgery cases.

Original languageEnglish (US)
Pages (from-to)1990-1995
Number of pages6
JournalJournal of Urology
Volume176
Issue number5
DOIs
StatePublished - Nov 2006
Externally publishedYes

Fingerprint

Nephrons
Renal Cell Carcinoma
Nephrectomy
Kidney
Survival Rate
Neoplasms
Registries

Keywords

  • carcinoma
  • neoplasm metastasis
  • renal cell

ASJC Scopus subject areas

  • Urology

Cite this

Krambeck, A., Leibovich, B. C., Lohse, C. M., Kwon, E. D., Zincke, H., & Blute, M. L. (2006). The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma. Journal of Urology, 176(5), 1990-1995. https://doi.org/10.1016/j.juro.2006.07.015

The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma. / Krambeck, Amy; Leibovich, Bradley C.; Lohse, Christine M.; Kwon, Eugene D.; Zincke, Horst; Blute, Michael L.

In: Journal of Urology, Vol. 176, No. 5, 11.2006, p. 1990-1995.

Research output: Contribution to journalArticle

Krambeck, A, Leibovich, BC, Lohse, CM, Kwon, ED, Zincke, H & Blute, ML 2006, 'The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma', Journal of Urology, vol. 176, no. 5, pp. 1990-1995. https://doi.org/10.1016/j.juro.2006.07.015
Krambeck, Amy ; Leibovich, Bradley C. ; Lohse, Christine M. ; Kwon, Eugene D. ; Zincke, Horst ; Blute, Michael L. / The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma. In: Journal of Urology. 2006 ; Vol. 176, No. 5. pp. 1990-1995.
@article{c9f2e7ac8d474844a72f807173a12b36,
title = "The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma",
abstract = "Purpose: Studies have demonstrated increased time to progression when cytoreductive nephrectomy is performed for metastatic renal cell carcinoma. We evaluated the role of nephron sparing surgery in these patients. Materials and Methods: We selected all patients with pM1 renal cell carcinoma treated with nephron sparing surgery or radical nephrectomy, and all patients with pM0 renal cell carcinoma undergoing nephron sparing surgery for solitary kidney from 1970 to 2002 from the Mayo Clinic Nephrectomy Registry. Results: We identified 16 patients who underwent nephron sparing surgery for pM1 renal cell carcinoma. Solitary kidney was present in 12, 3 had bilateral synchronous disease and 1 had elective nephron sparing surgery. Cancer specific survival rates at 1, 3 and 5 years were 81{\%}, 49{\%} and 49{\%}, respectively. We identified 404 patients who underwent radical nephrectomy for pM1 renal cell carcinoma. Cancer specific survival rates at 1, 3 and 5 years were 51{\%}, 21{\%} and 13{\%}, respectively. The pM1 nephron sparing surgery for solitary kidney cases were more likely to have early (33{\%} vs 10{\%}, p = 0.009) or late (50{\%} vs 19{\%}, p = 0.018) complications compared with pM1 radical nephrectomy cases. There were no significant differences in early (p = 0.475) or late (p = 0.350) complications between pM1 nephron sparing surgery cases and 139 pM0 nephron sparing surgery cases. Conclusions: Cancer specific survival rates in pM1 nephron sparing surgery cases were comparable to pM1 radical nephrectomy cases. Although there were differences in early and late complications between the pM1 nephron sparing surgery and pM1 radical nephrectomy groups, there were no differences when compared with imperative pM0 nephron sparing surgery cases. This study demonstrates that nephron sparing surgery can achieve adequate cytoreductive therapy while preserving renal function, with postoperative complication rates similar to those of pM0 nephron sparing surgery cases.",
keywords = "carcinoma, neoplasm metastasis, renal cell",
author = "Amy Krambeck and Leibovich, {Bradley C.} and Lohse, {Christine M.} and Kwon, {Eugene D.} and Horst Zincke and Blute, {Michael L.}",
year = "2006",
month = "11",
doi = "10.1016/j.juro.2006.07.015",
language = "English (US)",
volume = "176",
pages = "1990--1995",
journal = "Journal of Urology",
issn = "0022-5347",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - The Role of Nephron Sparing Surgery for Metastatic (pM1) Renal Cell Carcinoma

AU - Krambeck, Amy

AU - Leibovich, Bradley C.

AU - Lohse, Christine M.

AU - Kwon, Eugene D.

AU - Zincke, Horst

AU - Blute, Michael L.

PY - 2006/11

Y1 - 2006/11

N2 - Purpose: Studies have demonstrated increased time to progression when cytoreductive nephrectomy is performed for metastatic renal cell carcinoma. We evaluated the role of nephron sparing surgery in these patients. Materials and Methods: We selected all patients with pM1 renal cell carcinoma treated with nephron sparing surgery or radical nephrectomy, and all patients with pM0 renal cell carcinoma undergoing nephron sparing surgery for solitary kidney from 1970 to 2002 from the Mayo Clinic Nephrectomy Registry. Results: We identified 16 patients who underwent nephron sparing surgery for pM1 renal cell carcinoma. Solitary kidney was present in 12, 3 had bilateral synchronous disease and 1 had elective nephron sparing surgery. Cancer specific survival rates at 1, 3 and 5 years were 81%, 49% and 49%, respectively. We identified 404 patients who underwent radical nephrectomy for pM1 renal cell carcinoma. Cancer specific survival rates at 1, 3 and 5 years were 51%, 21% and 13%, respectively. The pM1 nephron sparing surgery for solitary kidney cases were more likely to have early (33% vs 10%, p = 0.009) or late (50% vs 19%, p = 0.018) complications compared with pM1 radical nephrectomy cases. There were no significant differences in early (p = 0.475) or late (p = 0.350) complications between pM1 nephron sparing surgery cases and 139 pM0 nephron sparing surgery cases. Conclusions: Cancer specific survival rates in pM1 nephron sparing surgery cases were comparable to pM1 radical nephrectomy cases. Although there were differences in early and late complications between the pM1 nephron sparing surgery and pM1 radical nephrectomy groups, there were no differences when compared with imperative pM0 nephron sparing surgery cases. This study demonstrates that nephron sparing surgery can achieve adequate cytoreductive therapy while preserving renal function, with postoperative complication rates similar to those of pM0 nephron sparing surgery cases.

AB - Purpose: Studies have demonstrated increased time to progression when cytoreductive nephrectomy is performed for metastatic renal cell carcinoma. We evaluated the role of nephron sparing surgery in these patients. Materials and Methods: We selected all patients with pM1 renal cell carcinoma treated with nephron sparing surgery or radical nephrectomy, and all patients with pM0 renal cell carcinoma undergoing nephron sparing surgery for solitary kidney from 1970 to 2002 from the Mayo Clinic Nephrectomy Registry. Results: We identified 16 patients who underwent nephron sparing surgery for pM1 renal cell carcinoma. Solitary kidney was present in 12, 3 had bilateral synchronous disease and 1 had elective nephron sparing surgery. Cancer specific survival rates at 1, 3 and 5 years were 81%, 49% and 49%, respectively. We identified 404 patients who underwent radical nephrectomy for pM1 renal cell carcinoma. Cancer specific survival rates at 1, 3 and 5 years were 51%, 21% and 13%, respectively. The pM1 nephron sparing surgery for solitary kidney cases were more likely to have early (33% vs 10%, p = 0.009) or late (50% vs 19%, p = 0.018) complications compared with pM1 radical nephrectomy cases. There were no significant differences in early (p = 0.475) or late (p = 0.350) complications between pM1 nephron sparing surgery cases and 139 pM0 nephron sparing surgery cases. Conclusions: Cancer specific survival rates in pM1 nephron sparing surgery cases were comparable to pM1 radical nephrectomy cases. Although there were differences in early and late complications between the pM1 nephron sparing surgery and pM1 radical nephrectomy groups, there were no differences when compared with imperative pM0 nephron sparing surgery cases. This study demonstrates that nephron sparing surgery can achieve adequate cytoreductive therapy while preserving renal function, with postoperative complication rates similar to those of pM0 nephron sparing surgery cases.

KW - carcinoma

KW - neoplasm metastasis

KW - renal cell

UR - http://www.scopus.com/inward/record.url?scp=33750289820&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33750289820&partnerID=8YFLogxK

U2 - 10.1016/j.juro.2006.07.015

DO - 10.1016/j.juro.2006.07.015

M3 - Article

C2 - 17070231

AN - SCOPUS:33750289820

VL - 176

SP - 1990

EP - 1995

JO - Journal of Urology

JF - Journal of Urology

SN - 0022-5347

IS - 5

ER -