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Medicina is published by MDPI from Volume 54 Issue 1 (2018). Articles in this Issue were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence. Articles are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Lithuanian Medical Association, Lithuanian University of Health Sciences, and Vilnius University.
Open AccessArticle

Comparison of Long-Term Results After Nephron-Sparing Surgery and Radical Nephrectomy in Treating 4- to 7-cm Renal Cell Carcinoma

1
Department of Urology, Medical Academy, Lithuanian University of Health Sciences
2
Department of Pathology, Medical Academy, Lithuanian University of Health Sciences
3
Lithuanian Cancer Registry, Institute of Oncology, Vilnius University, Lithuania
*
Author to whom correspondence should be addressed.
Medicina 2013, 49(5), 36; https://doi.org/10.3390/medicina49050036
Received: 5 May 2013 / Accepted: 30 May 2013 / Published: 4 June 2013
Objective. The aim of our study was to compare long-term oncological outcomes following nephron-sparing surgery (NSS) and radical nephrectomy (RN) for renal cell carcinoma (RCC) 4 to 7 cm in diameter.
Material and Methods
. The study included patients who underwent RN or NSS for RCC 4 to 7 cm in diameter between 1998 and 2009. The studied groups were compared with respect to the patients’ age, sex, physical status according to the American Society of Anesthesiologists Physical classification, histological type, stage, tumor size, grade, duration of the operation, and complications. Survival was established using the Kaplan-Meier method. The risk factors for survival were analyzed using a multivariate Cox regression model.
Results
. During the study, 351 patients underwent surgery: 317 patients (90.3%) underwent RN, and 34 (9.7%), NSS. The compared groups differed with respect to tumor size (P=0.001) and stage (P=0.006). The overall estimated 12-year survival was 53.7% after RN and 55.2% after NSS (log-rank test P=0.437). The 12-year cancer-specific survival in the RN and NSS groups was 69.6% and 80.6%, respectively (log-rank test P=0.198). Pathological stage and patients’ age were the major factors affecting both overall and cancer-specific survival. The type of surgery (NSS or RN) had no effect on survival.
Conclusions. Our study showed that nephron-sparing surgery is a safe technique compared with radical nephrectomy that ensures good oncological control in the treatment of renal cell carcinoma measuring 4 to 7 cm and may be proposed as the treatment of choice for renal tumors not only up to 4 cm, but also 4 to 7 cm in size.
Keywords: renal cell carcinoma; radical nephrectomy; nephron-sparing surgery; overall survival; cancer-specific survival renal cell carcinoma; radical nephrectomy; nephron-sparing surgery; overall survival; cancer-specific survival
MDPI and ACS Style

Milonas, D.; Skulčius, G.; Baltrimavičius, R.; Auškalnis, S.; Kinčius, M.; Matjošaitis, A.; Gudinavičienė, I.; Smailytė, G.; Jievaltas, M. Comparison of Long-Term Results After Nephron-Sparing Surgery and Radical Nephrectomy in Treating 4- to 7-cm Renal Cell Carcinoma. Medicina 2013, 49, 36.

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