Nephron-sparing Surgery May Not Consistently Improve Other-causes Survival

Elective nephron-sparing surgery (NSS) may not consistently improve other-causes survival relative to radical nephrectomy (RN) in all patients with kidney cancer, according to a study published in The Journal of Urology.¹

Researchers led by Alessandro Larcher, MD, of Università Vita-Salute San Raffaele in Italy, queried a collaborative database of 5 institutions to evaluate 1783 patients without chronic kidney disease who were diagnosed with clinical T1 renal mass treated with NSS or RN.

They used multivariable Cox regression analysis to assess the effect of surgery type on other-causes mortality after adjusting for patient and cancer characteristics.

Ten-year other-causes mortality rates were found to be 90% for NSS and 88% for RN. In contrast with NSS, RN was found to not be associated with an increased risk of other-causes mortality upon multivariable Cox regression analysis in the overall population.

“Sicker patients with relevant comorbidities are those who benefit the most from NSS in terms of other-causes mortality,” the authors concluded.

Reference

1. Larcher A, Capitanio U, Terrone C, Volpe, A, De Angelis, P, Deho F, et al. Elective nephron sparing surgery decreases other-causes mortality relative to radical nephrectomy only in specific subgroups of patients with renal cell carcinoma [published online ahead of print May 25, 2016.] J Urol. doi: 10.1016/j.juro.2016.04.093.