Prognostic factors of nephron sparing surgery for localized renal cell carcinoma

WANG Hai; JI Zhi-gang; NIU Ji-rui

doi:10.3760/cma.j.issn.1673-4777.2012.03.033

Abstract：Objective To evaluate the independent prognosis factors of survival for the nephron sparing surgery for localized renal cell carcinoma.Methods Totally 80 patients who were diagnosed of renal cell carcinoma between October 2000 and September 2009 were reviewed.The patients were divided into two groups:elective partial nephrectomy group with 68 patients with good contralateral renal function and imperative partial nephrectomy group with 12 patients with solitary renal carcinoma or poor contralateral renal function.Survival factors were evaluated by application of SPSS 17.0 statistical software.Results Mean tumor size was 3.5cm( 1.2-7.0 cm) with ≤4 cm in 68 cases(85.0％ ) and ＞4 cm in 12 cases( 15.0％ ).According to UICC2002TNM pathological staging,68 cases were in T1a stage(85.0％ ) and 12 cases in T1b stage( 15.0％ ).The patients were followed up for 12 to 107 months (mean 49.8 months).During follow-up 8 patients( 10％ ) died from tumour recurrence and (or)metastasis.Cancer specific 3-year and 5-year survival rates were 93.7％ and 85.5％,repectively.There was significant difference on survival rates between elective partial nephrectomy group and imperative partial nephrectomy group( log rank P ＜ 0.01 Multivariate analysis showed that surgical indication ( elective / imperative) was the only independent factor that had influence on cancer-specific survival ( P =0.03 RR =0.033 ).Conclusion Nephron sparing surgery for localized renal cell carcinoma has a good clinical efficacy,but the prognosis is relatively poor in patients with poor contralateral renal or with solitary renal carcinoma underwent NSS.