V.M. Grygorenko, A.P. Onyshchuk, M.V. Vikarchuk, R.O. Danylets, A.P. Nesterchuk, O.O. Banas, L.V. Pereta

Functional outcomes of nephron-sparing surgery for renal cell carcinoma T1b–T2 stage

Aim. To compare the functional outcomes of radical nephrectomy (NE) and partial nephrectomy (PN) in patients with T1b-T2 renal cell carcinoma (RCC).

Materials and methods. A retrospective assessment of the functional results of 167 patients with RCC clinical stage T1b-T2N0M0, which were operated in period from 2012 to 2015 were done. PN was performed in 79 patients (47.0%), NE - 88 (53.0%). Functional results were evaluated by determining the rate of glomerular filtration (GFR) using the Cockroft-Holt’s formula.

Results. In the PN and NE group, the GFR before surgery was 99.3 and 93.4 ml/min/1.73 m2 (p=0.284), after 7 days 86.3 and 76.5 ml/min/1.73 m2 (p=0.021), after 1 year after surgery 82.1 and 70.1 ml/min/1.73 m2 (p=0.0003), respectively. 1 After 1 year after surgery GFR decreased in the group of PN by 13.0%, in the group of NE - by 21.4% (p = 0.003). Also, after NE, the number of patients with III-IV stage of chronic kidney disease (CKD) increased by 21.2% (p=0.0023), after PN - did not change.

Conclusions. Retrospective evaluation of functional results of surgical treatment of T1b-T2 RCC in the early postoperative period and 1 year after surgery demonstrated that PN provides better preservation of functional renal parenchyma and renal function, as well as a decrease of the number of patients with clinically significant CKD, compared to NE.