Literature DB >> 19239445

Quality of life and perioperative outcomes after retroperitoneoscopic radical nephrectomy (RN), open RN and nephron-sparing surgery in patients with renal cell carcinoma.

Christian Gratzke1, Michael Seitz, Florian Bayrle, Boris Schlenker, Patrick J Bastian, Niko Haseke, Markus Bader, Derya Tilki, Alexander Roosen, Alexander Karl, Oliver Reich, Wael Y Khoder, Stephen Wyler, Christian G Stief, Michael Staehler, Alexander Bachmann.   

Abstract

OBJECTIVE: To prospectively evaluate health-related quality of life (HRQoL) and perioperative outcomes in patients with T1 and T2 renal cell carcinoma (RCC) after retroperitoneoscopic radical nephrectomy (RRN), open RN (ORN) or open nephron-sparing surgery (NSS). PATIENTS AND METHODS: The data of 117 patients who had undergone RRN (36), ORN (37) or NSS (44) were evaluated. RRN data were obtained at Basel University Hospital, Switzerland, while the ORN and NSS data were collected at the University of Munich, Germany. Perioperative outcomes were analysed and compared. HRQoL was prospectively evaluated based on the Short Form 36 questionnaire with a mean follow-up of 22 months.
RESULTS: Operative duration was significantly longer in the RRN group compared with the ORN and NSS groups, at a mean (sem) of 146 (42) min vs 113 (48) min and 114 (42) min (P < 0.001). In the RRN group intraoperative blood loss was lower than in the ORN and NSS groups, at a mean (sem) of 231 (153) mL vs 424 (361) mL and 494 (360) mL (P < 0.001). Morbidity rates were 13.9% for RRN, 16.2% for ORN and 20.5% for NSS, the most relevant complications being bleeding requiring transfusions in RRN and NSS patients and haemorrhage (5% of patients in each group). Creatinine values at 6 months after surgery only recovered completely in the NSS group. Patients in the ORN group had a trend towards higher mental well-being scores than patients in the RRN and NSS groups, with a mean Mental Component Summary Score of 48.3 vs 48.0 and 44.5, respectively (not statistically significant), while all patients were in similar physical condition after surgery, with a mean Physical Component Summary Scores of 48.0 (ORN), 47.4 (RRN) and 47.2 (NSS). The physical condition scores of patients in all groups were higher than scores reached by an age and sex-matched population (45.8).
CONCLUSION: These real-world data show that each of the surgical techniques can be considered safe. Importantly, after surgery patients reported high QoL scores independent of the technique used.

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Year:  2009        PMID: 19239445     DOI: 10.1111/j.1464-410X.2009.08439.x

Source DB:  PubMed          Journal:  BJU Int        ISSN: 1464-4096            Impact factor:   5.588


  35 in total

1.  [Organ and kidney function preservation in renal cell carcinoma].

Authors:  M Schenck; R Eder; H Rübben; C Niedworok; S Tschirdewahn
Journal:  Urologe A       Date:  2014-09       Impact factor: 0.639

2.  Comprehensive assessment of quality of life and psychosocial adjustment in patients with renal tumors undergoing open, laparoscopic and nephron sparing surgery.

Authors:  Patricia A Parker; Richard Swartz; Bryan Fellman; Diana Urbauer; Yisheng Li; Louis L Pisters; Charles J Rosser; Christopher G Wood; Surena F Matin
Journal:  J Urol       Date:  2012-01-15       Impact factor: 7.450

Review 3.  Trends in surgical management of T1 renal cell carcinoma.

Authors:  Jonas Schiffmann; Marco Bianchi; Maxine Sun; Andreas Becker
Journal:  Curr Urol Rep       Date:  2014-02       Impact factor: 3.092

Review 4.  [Standard surgery for small renal masses (<4 cm)].

Authors:  S K Frees; R Mager; H Borgmann; W Jäger; C Thomas; A Haferkamp
Journal:  Urologe A       Date:  2018-03       Impact factor: 0.639

Review 5.  Renal Functional Outcomes after Surgery, Ablation, and Active Surveillance of Localized Renal Tumors: A Systematic Review and Meta-Analysis.

Authors:  Hiten D Patel; Phillip M Pierorazio; Michael H Johnson; Ritu Sharma; Emmanuel Iyoha; Mohamad E Allaf; Eric B Bass; Stephen M Sozio
Journal:  Clin J Am Soc Nephrol       Date:  2017-05-08       Impact factor: 8.237

Review 6.  Management of Renal Masses and Localized Renal Cancer: Systematic Review and Meta-Analysis.

Authors:  Phillip M Pierorazio; Michael H Johnson; Hiten D Patel; Stephen M Sozio; Ritu Sharma; Emmanuel Iyoha; Eric B Bass; Mohamad E Allaf
Journal:  J Urol       Date:  2016-05-06       Impact factor: 7.450

Review 7.  Robot-assisted partial nephrectomy: current status, techniques, and future directions.

Authors:  Paurush Babbar; Ashok K Hemal
Journal:  Int Urol Nephrol       Date:  2011-02-25       Impact factor: 2.370

Review 8.  [Social medicine assessment after surgical and targeted treatment of renal cell cancer].

Authors:  W Vahlensieck; W Hoffmann; D-H Zermann
Journal:  Urologe A       Date:  2016-12       Impact factor: 0.639

9.  Advances of multidetector computed tomography in the characterization and staging of renal cell carcinoma.

Authors:  Athina C Tsili; Maria I Argyropoulou
Journal:  World J Radiol       Date:  2015-06-28

10.  Cost-utility analysis of radical nephrectomy versus partial nephrectomy in the management of small renal masses: Adjusting for the burden of ensuing chronic kidney disease.

Authors:  Zachary Klinghoffer; Jean-Eric Tarride; Giacomo Novara; Vincenzo Ficarra; Anil Kapoor; Bobby Shayegan; Luis H Braga
Journal:  Can Urol Assoc J       Date:  2013 Mar-Apr       Impact factor: 1.862

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