Impact of nephron-sparing surgery on quality of life in patients with localized renal cell carcinoma.
OBJECTIVE
The aim of the study is to evaluate the impact of nephron-sparing surgery on postoperative quality of life (QOL) in patients with localized renal cell carcinoma, compared with radical nephrectomy.


METHODS
From 1986 to 1996, a total of 66 patients with localized small renal cell carcinoma <4 cm in diameter and a functioning contralateral renal unit underwent radical nephrectomy (n = 51) or nephron-sparing surgery (n = 15). Of these, 50 patients evaluated various dimensions of QOL using standardized self-rating questionnaires, EORTC QLQ-C30.


RESULTS
There is no significant difference in 5-year overall survival between the nephron-sparing surgery group and the radical nephrectomy group. With regard to postoperative QOL, patients who underwent nephron-sparing surgery showed a significantly higher score on physical function than patients treated with radical nephrectomy (p<0.05). Nephron-sparing surgery was additionally superior to radical nephrectomy in terms of fatigue, sleep disturbance, pain and constipation.


CONCLUSIONS
Selected patients with localized, small, unilateral renal cell carcinoma and a normal contralateral kidney will benefit from nephron-sparing surgery.
Shinohara
N
N
Department of Urology, Hokkaido University School of Medicine, Sapporo, Japan. nobuo-s@med.hokudai.ac.jp
Harabayashi
T
T
Sato
S
S
Hioka
T
T
Tsuchiya
K
K
Koyanagi
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000379:methods*; D009399:Nephrons; D011788:Quality of Life; D012189:Retrospective Studies