TY - JOUR
T1 - Efficacy of nephron-sparing surgery for renal cell carcinoma
T2 - Analysis based on the new 1997 tumor-node-metastasis staging system
AU - Belldegrun, Arie
AU - Tsui, Ke Hung
AU - DeKernion, Jean B.
AU - Smith, Robert B.
PY - 1999/9
Y1 - 1999/9
N2 - Purpose: To analyze the experience with nephron-sparing surgery as a treatment modality for renal cell carcinoma (RCC). Patients and Methods: Between 1980 and 1997, 146 patients underwent partial nephrectomy at the University of California-Los Angeles Medical Center. A matched group of 125 patients who underwent radical nephrectomy at the same institution between 1986 and 1997 were selected for comparison. Patients were monitored for an average period of 57 months. Patients were staged according to both the 1997 and 1987 tumornode-metastasis (TNM) staging criteria. Survival data were calculated in terms of both staging criteria. Results: When comparing cancer- specific survival rates for patients with T1 lesions under both the 1987 and 1997 TNM staging criteria, no statistically significant difference in survival was noted (P = .53), although most of the tumors in our series measured ≤ 4 cm. Patients with T2 lesions (1997 TNM) demonstrated a significant decrease in survival (66%) when compared with patients with T1 lesions (100%; P < .001). No statistically significant difference in survival for patients with T1 RCC treated with either radical or partial nephrectomy was noted (P = .219). Survival rates of partial and radical nephrectomies for patients with unilateral T1 RCC and a normal contralateral kidney also were not significantly different (P = .53). In contrast, for patients with lesions greater than T1, survival rates were significantly higher with radical versus partial nephrectomy (P = .001). Conclusion: Partial nephrectomy has become an effective method of treating T1 RCC lesions as categorized by both the 1987 and the revised 1997 TNM staging criteria. Selected patients with localized unilateral RCC lesions less than 7 cm (ideally, < 4 cm) and a normal contralateral kidney will benefit from partial nephrectomy.
AB - Purpose: To analyze the experience with nephron-sparing surgery as a treatment modality for renal cell carcinoma (RCC). Patients and Methods: Between 1980 and 1997, 146 patients underwent partial nephrectomy at the University of California-Los Angeles Medical Center. A matched group of 125 patients who underwent radical nephrectomy at the same institution between 1986 and 1997 were selected for comparison. Patients were monitored for an average period of 57 months. Patients were staged according to both the 1997 and 1987 tumornode-metastasis (TNM) staging criteria. Survival data were calculated in terms of both staging criteria. Results: When comparing cancer- specific survival rates for patients with T1 lesions under both the 1987 and 1997 TNM staging criteria, no statistically significant difference in survival was noted (P = .53), although most of the tumors in our series measured ≤ 4 cm. Patients with T2 lesions (1997 TNM) demonstrated a significant decrease in survival (66%) when compared with patients with T1 lesions (100%; P < .001). No statistically significant difference in survival for patients with T1 RCC treated with either radical or partial nephrectomy was noted (P = .219). Survival rates of partial and radical nephrectomies for patients with unilateral T1 RCC and a normal contralateral kidney also were not significantly different (P = .53). In contrast, for patients with lesions greater than T1, survival rates were significantly higher with radical versus partial nephrectomy (P = .001). Conclusion: Partial nephrectomy has become an effective method of treating T1 RCC lesions as categorized by both the 1987 and the revised 1997 TNM staging criteria. Selected patients with localized unilateral RCC lesions less than 7 cm (ideally, < 4 cm) and a normal contralateral kidney will benefit from partial nephrectomy.
UR - http://www.scopus.com/inward/record.url?scp=0032877666&partnerID=8YFLogxK
U2 - 10.1200/jco.1999.17.9.2868
DO - 10.1200/jco.1999.17.9.2868
M3 - 文章
C2 - 10561364
AN - SCOPUS:0032877666
SN - 0732-183X
VL - 17
SP - 2868
EP - 2875
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 9
ER -