Sharafeldeen Mohamed, Sameh Wael, Mehrnoush Vahid, Alaref Amer, Rozenberg Radu, Ismail Asmaa, Elmansy Hazem, Shahrour Walid, Zakaria Ahmed, Elmeslemany Osama, Burute Nishigandha, Shuster Anatoly, Prowse Owen, Kotb Ahmed
Department of Urology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Department of Urology, Northern Ontario School of Medicine, Thunder Bay, Ontario, Canada.
J Kidney Cancer VHL. 2022 Oct 6;9(4):1-5. doi: 10.15586/jkcvhl.v9i4.255. eCollection 2022.
The aim of our study was to show our short-term experience in managing large renal masses (cT1b/T2) through partial nephrectomy (PN) over the last 3 years. Retrospective data collection for all patients managed by PN for renal masses larger than 4 cm over the last 3 years. Epidemiological data were collected. Surgical data including surgical and ischemic times as well as intra and postoperative complications were collected. Pre- and postoperative estimated glomerular filtration rate (eGFR) data were collected and correlated as well as postoperative complications and recurrence. We could identify 47 patients managed by PN for radiologically confirmed >4 cm renal masses. The mean age of the patients was 55.7 ± 13.4, including 29 males and 18 females. Masses were T1b and T2 in 40 and 7 patients, respectively. The mean tumor size was 6.2 ± 1.5 cm. Using renal nephrometry score; 8, 28, and 11 had low, moderate, and high complexity, respectively. Renal cell carcinoma (RCC) was identified in 42 patients. Five patients out of 42 cancerous cases (12%) had pathological T3 RCC. The mean preoperative and postoperative eGFR were 89.09 ± 12.41 and 88.50 ± 10.50, respectively (P 0.2). The median follow-up was 14 months and within that short time, no patient had evidence for cancer recurrence. PN for large renal masses is safe in experienced hands and should be attempted in a higher percentage of patients, regardless of the tumor complexity. No cancer recurrence or deterioration of renal function was observed within our short-term follow-up.
我们研究的目的是展示过去3年中我们通过部分肾切除术（PN）治疗大型肾肿块（cT1b/T2）的短期经验。回顾性收集过去3年中接受PN治疗的所有大于4 cm肾肿块患者的数据。收集流行病学数据。收集手术数据，包括手术时间和缺血时间以及术中及术后并发症。收集术前和术后估计肾小球滤过率（eGFR）数据并进行相关性分析，以及术后并发症和复发情况。我们确定了47例接受PN治疗的经放射学证实的>4 cm肾肿块患者。患者的平均年龄为55.7±13.4岁，其中男性29例，女性18例。肿块分别为T1b和T2期的患者有40例和7例。平均肿瘤大小为6.2±1.5 cm。根据肾计量评分，8例、28例和11例分别具有低、中、高复杂性。42例患者被确诊为肾细胞癌（RCC）。42例癌症病例中有5例（12%）为病理T3期RCC。术前和术后eGFR的平均值分别为89.09±12.41和88.50±10.50（P 0.2）。中位随访时间为14个月，在这段短时间内，没有患者有癌症复发的迹象。对于大型肾肿块，由经验丰富的医生进行PN是安全的，无论肿瘤复杂性如何，都应在更高比例的患者中尝试。在我们的短期随访中未观察到癌症复发或肾功能恶化。
