Elective nephron-sparing surgery for renal cell carcinoma: Trifecta outcomes in a university teaching hospital

Abstract

Objective: To report the trifecta results ofnephron-sparing surgery (NSS) for renalcell carcinoma (RCC).Patients and Methods: This is a retro-spective review of patients with RCC whounderwent NSS as elective indication.Between January 2001 and December2014, 112 patients with unilateral RCCand a normal contralateral kidney under-went PN. Patients with previous nephrec-tomy, bilateral or multiple RCCs,metastasis and familial cancer syndromeswere excluded.Results: In our cohort. 61.4% had openPN, 14.9% had laparoscopic PN and23.7% had robotic PN. Median follow upwas 61.8 months. Overall complicationrate was 7.0%, with 2.6% being Clavian IIIor above (1 case of bleeding and 2 cases ofurinary leakage/fistula). The positive mar-gin rate was 2.7% and local recurrence ratewas 0.9%. 43.0% of the patients developed chronic kidney disease (glomerular filtra-tion rate <60). The 5-year overall survival(OS) was 83.1% and cancer-specific sur-vival (CSS) was 97.4%. Subgroup analysisshowed that there was no difference inpostoperative GFR between the group withopen PN (mean GFR 55.7) and minimallyinvasive PN (mean GFR 54.6), p = 0.87.Conclusion: This retrospective study sug-gests a low complication rate, preservationof renal function and high 5-year CSS ofNSS comparable to international series.