Pierre Bigot1, Jean-François Hétet2, Jean-Christophe Bernhard3, Tarek Fardoun4, François Audenet5, Evanguelos Xylinas6, Guillaume Ploussard7, Géraldine Pignot8, Thomas Bessede9, Idir Ouzaid10, Edouard Robine11, Laurent Brureau12, Olivier Merigot de Treigny13, Charlotte Maurin9, Jean-Alexandre Long14, Jean Rouffilange15, Nicolas Hoarau16, Souhil Lebdai16, Morgan Rouprêt17, Laurence Bastien7, Yann Neuzillet18, Pierre Mongiat-Artus7, Grégory Verhoest4, Marc Zerbib6, Vincent Ravery10, Jérôme Rigaud19, Laurent Bellec13, Hervé Baumert20, Denis Chautard16, Karim Bensalah21, Bernard Escudier22, Philippe Paparel23, Nicolas Grenier24, Nathalie Rioux-Leclercq25, Abdel-Rahmène Azzouzi16, Michel Soulié26, Jean-Jacques Patard27. 1. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Angers University Hospital, Angers, France. 2. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Clinique Jules Verne, Nantes, France. 3. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Pellegrin University Hospital, Bordeaux, France. 4. Department of Urology, Pontchaillou University Hospital, Rennes, France. 5. Department of Urology, La Pitié Salpetrière University Hospital, Paris, France. 6. Paris Descartes University, Cochin Hospital, APHP, Paris, France. 7. Department of Urology, Saint-Louis University Hospital, APHP, Paris, France. 8. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France. 9. Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France. 10. Department of Urology, Bichat University Hospital, APHP, Paris, France. 11. Department of Urology, Nantes University Hospital, Nantes, France. 12. Department of Urology, Foch University Hospital, Suresnes, France. 13. Department of Urology, Toulouse University Hospital, Toulouse, France. 14. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Grenoble University Hospital, Grenoble, France. 15. Department of Urology, Pellegrin University Hospital, Bordeaux, France. 16. Department of Urology, Angers University Hospital, Angers, France. 17. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, La Pitié Salpetrière University Hospital, Paris, France. 18. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Foch University Hospital, Suresnes, France. 19. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Nantes University Hospital, Nantes, France. 20. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Saint-Joseph Hospital, Paris, France. 21. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Pontchaillou University Hospital, Rennes, France. 22. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France. 23. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Lyon Sud University Hospital, Lyon, France. 24. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Radiology, Pellegrin University Hospital, Bordeaux, France. 25. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Pathology, Pontchaillou University Hospital, Rennes, France. 26. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Toulouse University Hospital, Toulouse, France. 27. Cancerology Committee of the French Association of Urology (CCAFU), Paris, France; Department of Urology, Bicêtre University Hospital, Le Kremlin Bicêtre, France. Electronic address: jean-jacques.patard@bct.aphp.fr.
Abstract
BACKGROUND: The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors > 7 cm. MATERIALS AND METHODS: We retrospectively analyzed data from 168 patients with tumors > 7 cm who were treated using NSS between 1998 and 2012. RESULTS: Imperative and elective indications accounted for 76 (45.2%) and 92 (54.8%) patients, respectively. Major perioperative complications and renal function deterioration occurred in 33 (19.6%) and 51 patients (30.4%), respectively. In multivariate analysis, age older than 60 years (P = .001; hazard ratio [HR], 5) and tumor malignancy (P = .014; HR, 6.7) were prognostic factors for renal function deterioration whereas imperative indication was a risk factor for major postoperative complications (P = .0019; HR, 2.7). In 126 (75%) patients with malignant tumors, after a median follow-up of 30 months (range, 1-254 months), 25 patients (20.2%) died. In multivariate analysis, imperative indication (P = .023; HR, 4.2), positive surgical margin (P = .021; HR, 3.3), and Fuhrman grade > II (P = .013; HR, 3.7) were prognostic indicators for cancer-free survival (CFS). Imperative indication (P = .04; HR, 8.5) and Fuhrman grade > II (P = .04; HR, 3.9) were predictive factors of cancer-specific survival (CSS). In case of elective indication, positive surgical margin, local recurrence, and cancer-related death occurred in 4 (7.6%), 1 (1.1%), and 1 (1.1%) cases, respectively. For elective indication, 5-year estimates of CFS, CSS, and overall survival rates were: 85.7%, 98%, and 93.9%, respectively. CONCLUSION: In this selected population, imperative vs. elective indication status seems to play a critical role in oncologic outcomes. Oncologic results for elective indications are close to those reported with radical nephrectomy.
BACKGROUND: The purpose of this study was to evaluate morbidity, functional, and oncological outcomes after NSS in renal tumors > 7 cm. MATERIALS AND METHODS: We retrospectively analyzed data from 168 patients with tumors > 7 cm who were treated using NSS between 1998 and 2012. RESULTS: Imperative and elective indications accounted for 76 (45.2%) and 92 (54.8%) patients, respectively. Major perioperative complications and renal function deterioration occurred in 33 (19.6%) and 51 patients (30.4%), respectively. In multivariate analysis, age older than 60 years (P = .001; hazard ratio [HR], 5) and tumor malignancy (P = .014; HR, 6.7) were prognostic factors for renal function deterioration whereas imperative indication was a risk factor for major postoperative complications (P = .0019; HR, 2.7). In 126 (75%) patients with malignant tumors, after a median follow-up of 30 months (range, 1-254 months), 25 patients (20.2%) died. In multivariate analysis, imperative indication (P = .023; HR, 4.2), positive surgical margin (P = .021; HR, 3.3), and Fuhrman grade > II (P = .013; HR, 3.7) were prognostic indicators for cancer-free survival (CFS). Imperative indication (P = .04; HR, 8.5) and Fuhrman grade > II (P = .04; HR, 3.9) were predictive factors of cancer-specific survival (CSS). In case of elective indication, positive surgical margin, local recurrence, and cancer-related death occurred in 4 (7.6%), 1 (1.1%), and 1 (1.1%) cases, respectively. For elective indication, 5-year estimates of CFS, CSS, and overall survival rates were: 85.7%, 98%, and 93.9%, respectively. CONCLUSION: In this selected population, imperative vs. elective indication status seems to play a critical role in oncologic outcomes. Oncologic results for elective indications are close to those reported with radical nephrectomy.
Authors: Q Tang; R C Lin; L Yao; Z Zhang; H Hao; C J Zhang; L Cai; X S Li; Z S He; L Q Zhou Journal: Beijing Da Xue Xue Bao Yi Xue Ban Date: 2019-08-18
Authors: Byron H Lee; Andrew Feifer; Michael A Feuerstein; Nicole E Benfante; Lei Kou; Changhong Yu; Michael W Kattan; Paul Russo Journal: Eur Urol Focus Date: 2016-07-28
Authors: B Reix; J-C Bernhard; J-J Patard; P Bigot; A Villers; E Suer; N S Vuong; G Verhoest; Q Alimi; J-B Beauval; T Benoit; F-X Nouhaud; C Lenormand; N Hamidi; J Cai; M Eto; S Larre; A El Bakhri; G Ploussard; A Hung; N Koutlidis; A Schneider; J Carrouget; S Droupy; S Marchal; A Doerfler; S Seddik; T Matsugasumi; X Orsoni; A Descazeaud; C Pfister; K Bensalah; M Soulie; I Gill; V Flamand Journal: Prog Urol Date: 2018-01-11 Impact factor: 1.090