Chan Woo Cho1, Kyo Won Lee1, Hyojun Park1, Hyung Joon Kim1, Jae Berm Park1, Yoon-La Choi2, Jeong Il Yu3, Su Jin Lee4, Dong Il Choi5, Sung Joo Kim1. 1. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 3. Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 4. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. 5. Department of Diagnostic Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Abstract
AIM: The purpose of this study was to evaluate the efficacy of en bloc nephrectomy for perirenal retroperitoneal sarcoma (RPS) with respect to postoperative kidney function and oncological benefits. METHODS: We performed a comparative study of 114 patients undergoing surgery for primary RPS, classifying cases as nephrectomy (NPX, n = 65) versus no nephrectomy (no-NPX, n = 49). The Δ and % change between preoperative and postoperative estimated glomerulus filtration rate (eGFR) were analyzed to compare renal function changes after surgery. Kaplan-Meier analysis was performed to verify the incidence of local relapse between the two groups. RESULTS: During a median follow-up of 29 months, median postoperative GFR of 65 patients in the NPX group decreased to 73.5% of preoperative eGFR. Although 38 patients (58%) in the NPX group experienced a progression in chronic kidney disease stage after nephrectomy, no patients progressed to end-stage renal disease (ESRD). In French Federation of Cancer Centers Sarcoma grade 2, the NPX group had statistically significant local control benefits, compared with the no-NPX group (P = 0.048). CONCLUSIONS: Residual renal function after en bloc nephrectomy was stabilized without progression to ESRD. Moreover, en bloc nephrectomy for perirenal RPS might secure a complete resection margin for local tumor control.
AIM: The purpose of this study was to evaluate the efficacy of en bloc nephrectomy for perirenal retroperitoneal sarcoma (RPS) with respect to postoperative kidney function and oncological benefits. METHODS: We performed a comparative study of 114 patients undergoing surgery for primary RPS, classifying cases as nephrectomy (NPX, n = 65) versus no nephrectomy (no-NPX, n = 49). The Δ and % change between preoperative and postoperative estimated glomerulus filtration rate (eGFR) were analyzed to compare renal function changes after surgery. Kaplan-Meier analysis was performed to verify the incidence of local relapse between the two groups. RESULTS: During a median follow-up of 29 months, median postoperative GFR of 65 patients in the NPX group decreased to 73.5% of preoperative eGFR. Although 38 patients (58%) in the NPX group experienced a progression in chronic kidney disease stage after nephrectomy, no patients progressed to end-stage renal disease (ESRD). In French Federation of Cancer Centers Sarcoma grade 2, the NPX group had statistically significant local control benefits, compared with the no-NPX group (P = 0.048). CONCLUSIONS: Residual renal function after en bloc nephrectomy was stabilized without progression to ESRD. Moreover, en bloc nephrectomy for perirenal RPS might secure a complete resection margin for local tumor control.
Authors: Christopher C Stahl; Patrick B Schwartz; Cecilia G Ethun; Nicholas Marka; Bradley A Krasnick; Thuy B Tran; George A Poultsides; Kevin K Roggin; Ryan C Fields; Callisia N Clarke; Konstantinos I Votanopoulos; Kenneth Cardona; Daniel E Abbott Journal: Ann Surg Oncol Date: 2020-11-04 Impact factor: 5.344