PURPOSE: Patients with hereditary renal cancer are at increased risk for recurrent bilateral multifocal tumors and may require aggressive nephron sparing surgery to prevent renal replacement therapy. We evaluated feasibility and outcomes in patients who underwent partial nephrectomy with removal of at least 20 tumors in a single renal unit at 1 setting. MATERIALS AND METHODS: We retrospectively reviewed the records of 30 patients who underwent a total of 34 partial nephrectomies with removal of at least 20 tumors at our institution from 1993 to 2008. Operative reports and hospital records were reviewed for perioperative data, and renal functional and oncologic outcomes. We compared preoperative and postoperative renal function with the 2-tailed t test. RESULTS: There were no deaths and only 1 renal unit was lost. A median of 26.5 tumors was removed. Median estimated blood loss was 3,500 ml and median operative time was 9 hours. Perioperative complications developed in greater than 50% of cases. There was a statistically significant decrease in the estimated glomerular filtration rate at 3 months (67 vs 59 ml/minute/1.73 m(2), p < 0.001). Only 1 patient had metastatic disease. Eight of the 34 operated kidneys required subsequent intervention during the median followup of 52 months (range 4 to 187). CONCLUSIONS: Aggressive partial nephrectomy to resect multiple tumors is technically feasible. There was a significant decrease in postoperative renal function but more than 80% of preoperative renal function was preserved in this cohort except in 1 patient. Also, oncologic outcomes were encouraging at intermediate term followup.
PURPOSE:Patients with hereditary renal cancer are at increased risk for recurrent bilateral multifocal tumors and may require aggressive nephron sparing surgery to prevent renal replacement therapy. We evaluated feasibility and outcomes in patients who underwent partial nephrectomy with removal of at least 20 tumors in a single renal unit at 1 setting. MATERIALS AND METHODS: We retrospectively reviewed the records of 30 patients who underwent a total of 34 partial nephrectomies with removal of at least 20 tumors at our institution from 1993 to 2008. Operative reports and hospital records were reviewed for perioperative data, and renal functional and oncologic outcomes. We compared preoperative and postoperative renal function with the 2-tailed t test. RESULTS: There were no deaths and only 1 renal unit was lost. A median of 26.5 tumors was removed. Median estimated blood loss was 3,500 ml and median operative time was 9 hours. Perioperative complications developed in greater than 50% of cases. There was a statistically significant decrease in the estimated glomerular filtration rate at 3 months (67 vs 59 ml/minute/1.73 m(2), p < 0.001). Only 1 patient had metastatic disease. Eight of the 34 operated kidneys required subsequent intervention during the median followup of 52 months (range 4 to 187). CONCLUSIONS: Aggressive partial nephrectomy to resect multiple tumors is technically feasible. There was a significant decrease in postoperative renal function but more than 80% of preoperative renal function was preserved in this cohort except in 1 patient. Also, oncologic outcomes were encouraging at intermediate term followup.
Authors: Christian P Pavlovich; McClellan M Walther; Peter L Choyke; Stephen E Pautler; Richard Chang; W Marston Linehan; Bradford J Wood Journal: J Urol Date: 2002-01 Impact factor: 7.450
Authors: Linda F Fried; Michael G Shlipak; Casey Crump; Anthony J Bleyer; John S Gottdiener; Richard A Kronmal; Lewis H Kuller; Anne B Newman Journal: J Am Coll Cardiol Date: 2003-04-16 Impact factor: 24.094
Authors: Carvell T Nguyen; Brian R Lane; Jihad H Kaouk; Nicholas Hegarty; Inderbir S Gill; Andrew C Novick; Steven C Campbell Journal: J Urol Date: 2008-05-15 Impact factor: 7.450
Authors: Brian R Lane; Denise C Babineau; Emilio D Poggio; Christopher J Weight; Benjamin T Larson; Inderbir S Gill; Andrew C Novick Journal: J Urol Date: 2008-10-18 Impact factor: 7.450
Authors: David S Finley; Shawn Beck; Geoffrey Box; William Chu; Leslie Deane; Duane J Vajgrt; Elspeth M McDougall; Ralph V Clayman Journal: J Urol Date: 2008-06-11 Impact factor: 7.450
Authors: Joseph A Baiocco; Mark W Ball; Asha K Pappajohn; Kareem N Rayn; Gennady Bratslavsky; Shawna L Boyle; William M Linehan; Adam R Metwalli Journal: Urol Oncol Date: 2019-03-20 Impact factor: 3.498
Authors: Eric A Singer; Srinivas Vourganti; Kelly Y Lin; Gopal N Gupta; Peter A Pinto; Ardeshir R Rastinehad; W Marston Linehan; Gennady Bratslavsky Journal: J Urol Date: 2012-10-18 Impact factor: 7.450
Authors: Ryan A Hankins; Annerleim Walton-Diaz; Hong Truong; Joanna Shih; Gennady Bratslavsky; Peter A Pinto; W Marston Linehan; Adam R Metwalli Journal: Int Urol Nephrol Date: 2016-08-11 Impact factor: 2.370
Authors: Gennady Bratslavsky; Thomas Sanford; Ramaprasad Srinivasan; Olga Aprelikova; Jack Liu; Martha Quezado; Maria Merino; W Marston Linehan Journal: J Cancer Date: 2011-05-12 Impact factor: 4.207