[Overall survival and renal function after partial and radical nephrectomy in malignant localized renal tumors.] / Supervivencia y función renal tras nefrectomía parcial y radical en tumores renales malignos localizados.

OBJECTIVE: To evaluate the overall survival rate and renal function in our series after radical nephrectomy (RN) and partial nephrectomy (PN) in renal tumors in an early stage. METHODS: We retrospectively reviewed the medical records of 229 patients who underwent RN or PN for renal cancer T1-T2N0M0 in our center between 1995 and 2015. We described demographic factors, first symptom, TNM, histology, post-surgery data, recurrence rate and renal function. We utilized Fisher test, Chi square test and T-Student and we considered statistical significance when p<0.05. RESULTS: 203 patients underwent RN and 26 PN. 39.4% of the tumors who received RN were T1bN0M0 and 76.92% of PN were T1aN0M0. We report nine complications grade II of modified Clavien System for RN and only one grade I for PN. We detected an 11.3% recurrence in RN and none in PN. 66%of patients from RN are alive today, 12.81% died as result of renal cancer and 22.7% suffered a non-cancer-specific death. No deaths were observed in PN group. We observed similar mean preoperative serum creatinine (Cr) in both groups. Creatinine after the first post-operative month was 1.81mg/dL and 1.06mg/dL for RN and PN, respectively; At one year post-operative we registered Cr 1.82mg/dL and Cr 0.97mg/dL, respectively. CONCLUSIONS: Both methods provide excellent oncologic results for renal carcinoma in an early stage. PN is safe and reduces the incidence of renal dysfunction with a lower rate of non-cancer-specific death.

Supervivencia y función renal tras nefrectomía parcial y radical en tumores renales malignos localizados / Overall survival and renal function after partial and radical nephrectomy in malignant localized renal tumors

OBJETIVO: Comparar resultados oncológicos y de preservación de función renal en nuestra serie de nefrectomías radicales (NR) y parciales (NP) en masas renales en estadios tempranos. MÉTODO: Se realizó un estudio retrospectivo en 229 pacientes intervenidos de cáncer renal T1-T2N0M0 desde 1995 hasta 2015. Se estudiaron datos demográficos, síntoma de debut, TNM, histología, datos post-operatorios, tasa de recidiva y de conservación de función renal. En el análisis estadístico se utilizó el test de Fisher, Chi cuadrado y T-Student. Se consideró significación estadística p < 0,05. RESULTADOS: En 203 casos se realizó NR y en 26 una NP. El 39,4% fueron T1bN0M0 en NR y el 76,92% T1aN0M0 en NP. Se recogieron nueve complicaciones grado II del Sistema Clavien modificado en las NR y un grado I en las NP. Se detectaron un 11,3% de recidivas en NR y ninguna en NP. El 66% de los enfermos de NR están vivos, el 12,81% fallecieron a consecuencia de su cáncer renal y el 22,7% murieron por otra causa. Ningún paciente de NP ha fallecido. En la evolución de la función renal se evidenciaron Cr previas medias similares en ambos grupos. Pasado un mes de la cirugía, Cr 1,81mg/dL y Cr 1,06mg/dL y tras un año Cr 1,82mg/dL y Cr 0,97mg/dL para NR y NP. CONCLUSIONES: Tanto la NP como la NR presentan una excelente tasa de control oncológico en cáncer renal en estadio temprano. La NP es segura y garantiza una mejor conservación de la función renal con menor mortalidad no cancero-específica

OBJECTIVE: To evaluate the overall survival rate and renal function in our series after radical nephrectomy (RN) and partial nephrectomy (PN) in renal tumors in an early stage. METHODS: We retrospectively reviewed the medical records of 229 patients who underwent RN or PN for renal cancer T1-T2N0M0 in our center between 1995 and 2015. We described hemographic factors, first symptom, TNM, histology, post-surgery data, recurrence rate and renal function. We utilized Fisher test, Chi square test and T-Student and we considered statistical significance when p < 0.05. RESULTS: 203 patients underwent RN and 26 PN. 39.4% of the tumors who received RN were T1bN0M0 and 76.92% of PN were T1aN0M0. We report nine complications grade II of modified Clavien System for RN and only one grade I for PN. We detected an 11.3% recurrence in RN and none in PN. 66% of patients from RN are alive today, 12.81% died as result of renal cancer and 22.7% suffered a non-cancer-specific death. No deaths were observed in PN group. We observed similar mean preoperative serum creatinine (Cr) in both groups. Creatinine after the first post-operative month was 1.81mg/dL and 1.06mg/dL for RN and PN, respectively; At one-year post-operative we registered Cr 1.82mg/dL and Cr 0.97mg/dL, respectively. CONCLUSIONS: Both methods provide excellent oncologic results for renal carcinoma in an early stage. PN is safe and reduces the incidence of renal dysfunction with a lower rate of non-cancer-specific death