Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis
PurposeThe study aimed to compare operative, functional, and oncological outcomes between partial nephrectomy (PN) and radical nephrectomy (RN) for entophytic renal tumors (ERTs) by propensity score matching (PSM) analysis.MethodsA total of 228 patients with ERTs who underwent PN or RN between Augus...
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| Format: | Article |
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Frontiers Media S.A.
2022-07-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2022.916018/full |
| _version_ | 1818002218307026944 |
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| author | Situ Xiong Situ Xiong Ming Jiang Ming Jiang Yi Jiang Yi Jiang Bing Hu Bing Hu Ru Chen Ru Chen Zhijun Yao Zhijun Yao Wen Deng Wen Deng Xianwen Wan Xiaoqiang Liu Luyao Chen Bin Fu Bin Fu |
| author_facet | Situ Xiong Situ Xiong Ming Jiang Ming Jiang Yi Jiang Yi Jiang Bing Hu Bing Hu Ru Chen Ru Chen Zhijun Yao Zhijun Yao Wen Deng Wen Deng Xianwen Wan Xiaoqiang Liu Luyao Chen Bin Fu Bin Fu |
| author_sort | Situ Xiong |
| collection | DOAJ |
| description | PurposeThe study aimed to compare operative, functional, and oncological outcomes between partial nephrectomy (PN) and radical nephrectomy (RN) for entophytic renal tumors (ERTs) by propensity score matching (PSM) analysis.MethodsA total of 228 patients with ERTs who underwent PN or RN between August 2014 and December 2021 were assessed. A PSM in a 1:1 ratio was conducted to balance the differences between groups. Perioperative characteristics, renal functional, and oncological outcomes were compared between groups. Univariate and multivariate logistic and Cox proportional hazard regression analyses were used to determine the predictors of functional and survival outcomes.ResultsAfter PSM, 136 cases were matched to the PN group (n = 68) and the RN group (n = 68). Patients who underwent RN had shorter OT, less EBL, and lower high-grade complications (all p <0.05) relative to those who underwent PN. However, better perseveration of renal function was observed in the PN group, which was reflected in 48-h postoperative AKI (44.1% vs. 70.6%, p = 0.002), 1-year postoperative 90% eGFR preservation (45.6% vs. 22.1%, p = 0.004), and new-onset CKD Stage ≥III at last follow-up (2.9% vs. 29.4%, p <0.001). RN was the independent factor of short-term (OR, 2.812; 95% CI, 1.369–5.778; p = 0.005) and long-term renal function decline (OR, 10.242; 95% CI, 2.175–48.240; p = 0.003). Furthermore, PN resulted in a better OS and similar PFS and CSS as compared to RN (p = 0.042, 0.15, and 0.21, respectively). RN (OR, 7.361; 95% CI, 1.143–47.423; p = 0.036) and pT3 stage (OR, 4.241; 95% CI, 1.079–16.664; p = 0.039) were independent predictors of overall mortality.ConclusionAmong patients with ERTs, although the PN group showed a higher incidence of high-grade complications than RN, when technically feasible and with experienced surgeons, PN is recommended for better preservation of renal function, longer OS, and similar oncological outcomes. |
| first_indexed | 2024-04-14T03:43:50Z |
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| id | doaj.art-056a4b2eb0bb4e8aa54a41f995e436ec |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-14T03:43:50Z |
| publishDate | 2022-07-01 |
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| series | Frontiers in Oncology |
| spelling | doaj.art-056a4b2eb0bb4e8aa54a41f995e436ec2022-12-22T02:14:24ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2022-07-011210.3389/fonc.2022.916018916018Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching AnalysisSitu Xiong0Situ Xiong1Ming Jiang2Ming Jiang3Yi Jiang4Yi Jiang5Bing Hu6Bing Hu7Ru Chen8Ru Chen9Zhijun Yao10Zhijun Yao11Wen Deng12Wen Deng13Xianwen Wan14Xiaoqiang Liu15Luyao Chen16Bin Fu17Bin Fu18Department of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The Second Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaDepartment of Anesthesiology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaDepartment of Urology, The First Affiliated Hospital of Nanchang University, Nanchang, ChinaJiangxi Institute of Urology, Nanchang, ChinaPurposeThe study aimed to compare operative, functional, and oncological outcomes between partial nephrectomy (PN) and radical nephrectomy (RN) for entophytic renal tumors (ERTs) by propensity score matching (PSM) analysis.MethodsA total of 228 patients with ERTs who underwent PN or RN between August 2014 and December 2021 were assessed. A PSM in a 1:1 ratio was conducted to balance the differences between groups. Perioperative characteristics, renal functional, and oncological outcomes were compared between groups. Univariate and multivariate logistic and Cox proportional hazard regression analyses were used to determine the predictors of functional and survival outcomes.ResultsAfter PSM, 136 cases were matched to the PN group (n = 68) and the RN group (n = 68). Patients who underwent RN had shorter OT, less EBL, and lower high-grade complications (all p <0.05) relative to those who underwent PN. However, better perseveration of renal function was observed in the PN group, which was reflected in 48-h postoperative AKI (44.1% vs. 70.6%, p = 0.002), 1-year postoperative 90% eGFR preservation (45.6% vs. 22.1%, p = 0.004), and new-onset CKD Stage ≥III at last follow-up (2.9% vs. 29.4%, p <0.001). RN was the independent factor of short-term (OR, 2.812; 95% CI, 1.369–5.778; p = 0.005) and long-term renal function decline (OR, 10.242; 95% CI, 2.175–48.240; p = 0.003). Furthermore, PN resulted in a better OS and similar PFS and CSS as compared to RN (p = 0.042, 0.15, and 0.21, respectively). RN (OR, 7.361; 95% CI, 1.143–47.423; p = 0.036) and pT3 stage (OR, 4.241; 95% CI, 1.079–16.664; p = 0.039) were independent predictors of overall mortality.ConclusionAmong patients with ERTs, although the PN group showed a higher incidence of high-grade complications than RN, when technically feasible and with experienced surgeons, PN is recommended for better preservation of renal function, longer OS, and similar oncological outcomes.https://www.frontiersin.org/articles/10.3389/fonc.2022.916018/fullendophytic renal tumorpartial nephrectomyradical nephrectomypropensity score matchingoncological outcomesfunction outcomes |
| spellingShingle | Situ Xiong Situ Xiong Ming Jiang Ming Jiang Yi Jiang Yi Jiang Bing Hu Bing Hu Ru Chen Ru Chen Zhijun Yao Zhijun Yao Wen Deng Wen Deng Xianwen Wan Xiaoqiang Liu Luyao Chen Bin Fu Bin Fu Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis Frontiers in Oncology endophytic renal tumor partial nephrectomy radical nephrectomy propensity score matching oncological outcomes function outcomes |
| title | Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis |
| title_full | Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis |
| title_fullStr | Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis |
| title_full_unstemmed | Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis |
| title_short | Partial Nephrectomy Versus Radical Nephrectomy for Endophytic Renal Tumors: Comparison of Operative, Functional, and Oncological Outcomes by Propensity Score Matching Analysis |
| title_sort | partial nephrectomy versus radical nephrectomy for endophytic renal tumors comparison of operative functional and oncological outcomes by propensity score matching analysis |
| topic | endophytic renal tumor partial nephrectomy radical nephrectomy propensity score matching oncological outcomes function outcomes |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2022.916018/full |
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