Comparing the long-term prognosis and renal function changes of partial nephrectomy (PN) and radical nephrectomy (RN) in T1 stage renal cell carcinoma patients

Date
2025
Language
American English
Embargo Lift Date
Committee Members
Degree
Degree Year
Department
Grantor
Journal Title
Journal ISSN
Volume Title
Found At
AME
Can't use the file because of accessibility barriers? Contact us with the title of the item, permanent link, and specifics of your accommodation need.
Abstract

Background: Radical nephrectomy (RN) and partial nephrectomy (PN) are common surgical treatments for T1 stage renal cell carcinoma (RCC). However, the long-term impact of these surgical approaches on prognosis and renal function remains an area of ongoing investigation. This study compared the effects of these procedures on prognosis and renal function.

Methods: The data of 1,030 T1 stage RCC patients treated at Peking University Cancer Hospital & Institute between January 2014 and August 2022 were analyzed. The primary endpoints of the study were overall survival (OS) and cancer-specific survival (CSS). The secondary endpoints included the annual mean estimated glomerular filtration rate (eGFR) and the average annual eGFR change rates.

Results: Based on a median follow-up time of 57 months, the OS and CSS rates were 96.6% and 98.5% in the overall cohort, respectively. The multivariate analysis identified age [hazard ratio (HR), 2.664; 95% confidence interval (CI): 1.147-6.192; P=0.02], tumor grade (HR, 2.247; 95% CI: 1.050-4.810; P=0.04), and surgical approach (HR, 2.585; 95% CI: 1.056-6.325; P=0.04) as adverse prognostic factors for OS, and age (HR, 4.603; 95% CI: 1.035-20.471; P=0.045) and tumor grade (HR, 4.972; 95% CI: 1.752-14.111; P=0.003) as adverse prognostic factors for CSS. Throughout the follow-up period, the eGFR of the RN patients showed a gradual increase, while that of the PN patients remained stable (P<0.001). Among the patients with preoperative diabetes, the eGFR of the RN patients decreased significantly compared to that of the PN patients (P=0.03).

Conclusions: T1 stage RCC has a favorable prognosis with surgery, and PN is an oncologically safe option. A persistent eGFR difference was observed between the PN and RN groups, with RN showing a gradual upward trend. However, patients with pre-existing diabetes experienced a greater decline in renal function after RN, which highlights the advantages of PN for such patients.

Description
item.page.description.tableofcontents
item.page.relation.haspart
Cite As
Cao Y, Cui Y, Li R, et al. Comparing the long-term prognosis and renal function changes of partial nephrectomy (PN) and radical nephrectomy (RN) in T1 stage renal cell carcinoma patients. Transl Androl Urol. 2025;14(3):740-750. doi:10.21037/tau-2025-136
ISSN
Publisher
Series/Report
Sponsorship
Major
Extent
Identifier
Relation
Journal
Translational Andrology and Urology
Source
PMC
Alternative Title
Type
Article
Number
Volume
Conference Dates
Conference Host
Conference Location
Conference Name
Conference Panel
Conference Secretariat Location
Version
Final published version
Full Text Available at
This item is under embargo {{howLong}}