Chronic kidney disease and clear renal cell carcinoma metastasis following radical or partial nephrectomy[Enfermedad renal crónica y aparición de metástasis posterior a nefrectomía radical y parcial por carcinoma renal de células claras]
Author
Fernández, Pehuén
De Arteaga, Javier
Chiurchiu, Carlos
Douthat, Walter
Naser, Sofía
Schwarz, Facundo
Borgogno, Pamela
Colla, Raúl
Sosa, Alejandro
De La Fuente, Jorge
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Introduction: Partial nephrectomy to treat early-stage renal cell carcinoma has become one of the surgeries of choice for patients in Argentina. However, long-term results in the country are unknown. In this study, we analyzed the progression to chronic kidney disease and the appearance of metastasis after partial or radical nephrectomy in renal cell carcinoma patients. Methods: A retrospective, cohort study was conducted. We included all patients suffering from T1 stage clear cell renal carcinoma who, between 2006 and 2012, underwent partial nephrectomy in our hospital. Follow-up continued until January 2018. Results: Thirty-two patients were included (19 had undergone radical nephrectomy and 13, partial nephrectomy). Subjects who had radical nephrectomy showed a more rapid progression to chronic kidney disease as compared to the subjects in the partial nephrectomy group (radical nephrectomy 63.2% vs. partial nephrectomy 15.4%; p=0.007). There were no differences in the follow-up period in both groups (radical nephrectomy 69.3% ± 23.8 months vs. partial nephrectomy 72.5 ± 26.9 months; p=0.73). Risk of progression to end-stage chronic kidney disease was 11 times higher for subjects who had undergone radical nephrectomy as compared to subjects who had had partial nephrectomy (adjusted HR 11.12; 95% CI: 1.24-99.9; p=0.031), adjusted by the rest of traditional risk factors. None of the T1a patients had metastasis during follow-up, regardless of the type of surgery. Conclusion: According to the findings of our study, partial nephrectomy preserves long-term renal function better than radical nephrectomy and has an excellent oncologic safety profile in T1a stage renal cell carcinoma patients. Radical nephrectomy was an independent risk factor of progression to chronic kidney disease.Fil: Fernández, Pehuén. Universidad Católica de Córdoba; Argentina
Fil: Arteaga, Javier De. Universidad Católica de Córdoba; Argentina
Fil: Chiurchiu, Carlos. Universidad Católica de Córdoba; Argentina
Fil: Douthat, Walter. Universidad Católica de Córdoba; Argentina
Fil: Naser, Sofía. Universidad Católica de Córdoba; Argentina
Fil: Schwarz, Facundo. Universidad Católica de Córdoba; Argentina
Fil: Borgogno, Pamela. Universidad Católica de Córdoba; Argentina
Fil: Colla, Raúl. Hospital Privado Centro médico de Córdoba; Argentina
Fil: Sosa, Alejandro. Hospital Privado Centro médico de Córdoba; Argentina
Fil: De La Fuente, Jorge. Universidad Católica de Córdoba; Argentina
Fil: Fernández, Pehuén. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Fernández, Pehuén. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Fernández, Pehuén. Fundación Nefrológica de Córdoba; Argentina
Fil: Arteaga, Javier De. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Arteaga, Javier De. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Arteaga, Javier De. Fundación Nefrológica de Córdoba; Argentina
Fil: Chiurchiu, Carlos. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Chiurchiu, Carlos. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Chiurchiu, Carlos. Fundación Nefrológica de Córdoba; Argentina
Fil: Douthat, Walter. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Douthat, Walter. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Douthat, Walter. Fundación Nefrológica de Córdoba; Argentina
Fil: Naser, Sofía. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Naser, Sofía. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Naser, Sofía. Fundación Nefrológica de Córdoba; Argentina
Fil: Schwarz, Facundo. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Schwarz, Facundo. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Schwarz, Facundo. Fundación Nefrológica de Córdoba; Argentina
Fil: Borgogno, Pamela. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: Borgogno, Pamela. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: Borgogno, Pamela. Fundación Nefrológica de Córdoba; Argentina
Fil: De La Fuente, Jorge. Hospital Privado Centro Médico de Córdoba; Argentina
Fil: De La Fuente, Jorge. Instituto Universitario de Ciencias Biomédicas de Córdoba; Argentina
Fil: De La Fuente, Jorge. Fundación Nefrológica de Córdoba; Argentina