Journal of Korean Medical Science

  • 제33권43호
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  • Pages.277.1-277.10
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  • 2018
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  • 1011-8934(pISSN)
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  • 1598-6357(eISSN)
대한의학회 (Korean Acad Medical Sciences)
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Partial versus Radical Nephrectomy for T1-T2 Renal Cell Carcinoma in Patients with Chronic Kidney Disease Stage III: a Multiinstitutional Analysis of Kidney Function and Survival Rate

  • Chung, Jae-Seung (Department of Urology, Inje University Haeundae Paik Hospital) ;
  • Son, Nak Hoon (Department of Biostatistics, Yonsei University) ;
  • Lee, Sang Eun (Department of Urology, Seoul National University Bundang Hospital) ;
  • Hong, Sung Kyu (Department of Urology, Seoul National University Bundang Hospital) ;
  • Jeong, Chang Wook (Department of Urology, Seoul National University Hospital) ;
  • Kwak, Cheol (Department of Urology, Seoul National University Hospital) ;
  • Kim, Hyeon Hoe (Department of Urology, Seoul National University Hospital) ;
  • Hong, Sung Hoo (Department of Urology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine) ;
  • Kim, Yong June (Department of Urology, Chungbuk National University Hospital) ;
  • Kang, Seok Ho (Department of Urology, Korea University Anam Hospital) ;
  • Chung, Jinsoo (Department of Urology, National Cancer Center) ;
  • Kwon, Tae Gyun (Department of Urology, Kyungpook National University Medical Center) ;
  • Hwang, Eu Chang (Department of Urology, Chonnam National University Hwasun Hospital) ;
  • Byun, Seok-Soo (Department of Urology, Seoul National University Bundang Hospital)
  • 투고 : 2018.03.11
  • 심사 : 2018.06.29
  • 발행 : 2018.10.22
⟨ 이전 논문 다음 논문 ⟩

초록

Background: To examine survival rates and renal function after partial nephrectomy (PN) and radical nephrectomy (RN) in patients with chronic kidney disease (CKD). Methods: We studied 4,332 patients who underwent PN or RN for pathological T1a-T2N0M0 renal cell carcinoma from 1988 to 2014. Patients were divided into two subgroups of CKD stage I-II and stage III. Kidney function, and survival outcomes were compared between groups. Results: We included 1,756 patients with CKD I-II and 276 patients with CKD III in the final pair-matched analysis. Kidney function was significantly better preserved in the PN than in the RN group among all patients. However, the beneficial effect of PN on kidney function gradually disappeared over time in CKD III patients. The 5-year overall survival (OS) rates after PN and RN differed in patients with CKD I-II disease (99.4% vs. 96.5%, respectively, P = 0.015). The 5-year OS rates after surgery were not affected by mode of nephrectomy in CKD III patients (97.8% vs. 93.5%, P = 0.103). The 5-year cancer-specific survival rates did not differ between treatment groups in all CKD stage. Cox hazard analysis showed that the operative method was a significant factor for OS in CKD I-II patients (hazard ratio [HR], 0.320; confidence interval [CI], 0.122-0.840; P = 0.021). However, PN was not beneficial in terms of OS in CKD III patients (HR, 0.395; CI, 0.086-1.172; P = 0.117). Conclusion: PN is associated with a higher OS rate and better kidney function in patients with preoperative CKD stage I and II, but not in those with CKD stage III.

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참고문헌

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피인용 문헌

  1. Methylation Signature for Prediction of Progression Free Survival in Surgically Treated Clear Cell Renal Cell Carcinoma vol.34, pp.19, 2018, https://doi.org/10.3346/jkms.2019.34.e144
  2. Partial versus radical nephrectomy in clinical T2 renal masses vol.28, pp.11, 2018, https://doi.org/10.1111/iju.14664