Surgical outcomes of partial nephrectomy for renal cell carcinoma: a joint study by the Japanese Society of Renal Cancer.
OBJECTIVE
A joint study was undertaken by the Japanese Society of Renal Cancer to investigate the present status of partial nephrectomy in Japan and to speculate about what may be the indications for partial nephrectomy in patients with renal cell carcinoma.


METHODS
Data were tabulated for 469 patients from participating medical institutions and various clinical factors were investigated with regard to disease progression (local recurrence and distant metastasis).


RESULTS
Disease progression was observed in 21 patients (4.5%). No significant relation to disease progression was observed for sex, laterality, tumor histology, grade and tumor size. Although patients with solitary tumors displayed excellent prognosis irrespective of tumor diameter, patients with multiple tumors displayed a high likelihood of disease progression. Patients older than 77 years old and patients with imperative indication were found to have a poorer prognosis.


CONCLUSIONS
In patients with solitary tumors, partial nephrectomy can be actively performed, even if the patient displays elective indications and the tumor is >4 cm in diameter. In patients displaying multiple tumors with imperative indications, the decision whether to perform partial nephrectomy should be made by the patients and their physicians after considering the impact on curability and the quality of life.
Senga
Yutaka
Y
Department of Urology, Chigasaki Municipal Hospital, Kanagawa, Japan. uro@cg.netlaputa.ne.jp
Ozono
Seiichiro
S
Nakazawa
Hayakazu
H
Nagamori
Satoshi
S
Marumo
Ken
K
Horie
Shigeo
S
Onishi
Tetsuro
T
Miyao
Noriomi
N
Nakao
Masahiro
M
Igarashi
Tatsuo
T
Tsushima
Tomoyasu
T
Hasegawa
Michihiko
M
Murai
Masaru
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D019538:Health Care Surveys; D006801:Humans; D007564:Japan; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D018579:Patient Selection; D016896:Treatment Outcome