title: The use of partial nephrectomy in European tertiary care centers.
abstract: OBJECTIVE
  The objective was to define the trends of PN use over time at six tertiary care European centers.
  
  
  METHODS
  Data were retrieved from institutional databases for patients treated with either PN or radical nephrectomy (RN) for stages T(1-2)N(0)M(0) renal cell carcinoma (RCC) between 1987 and 2007. For purpose of temporal trend analyses patients were divided into five equally sized groups according to the date of surgery. Categorical and multivariable logistic regression analyses assessed predictors of PN use.
  
  
  RESULTS
  Overall 597 (31.7%) patients were treated with PN. Overall, a 4.5-fold increase of PN was recorded. The absolute increases were 41.7-86.3%, 14.9-69.3% and 8.1-35.3% for lesions < or = 2 cm, 2.1-4 cm and 4.1-7 cm (chi-square trend test p<0.001), respectively. In multivariable logistic regression models, decreasing tumor size, younger age, more contemporary date of surgery, male gender and institutional PN rate represented independent predictors of the individual probability of treatment with PN. Lack of data from community hospitals limits the generalizability of our findings.
  
  
  CONCLUSIONS
  Based on data from six tertiary care centers, the contemporary rate of PN ranges from 86 to 35% for renal masses < or = 2 cm to 4.1-7 cm and is indicative of excellent quality of care.
authors.affiliation: Cancer Prognostics and Health Outcomes Unit, University of Montreal Health Center, Montreal, Quebec, Canada.
authors.forename: L
authors.initials: L
authors.lastname: Zini
authors.forename: J J
authors.initials: JJ
authors.lastname: Patard
authors.forename: U
authors.initials: U
authors.lastname: Capitanio
authors.forename: A
authors.initials: A
authors.lastname: Mejean
authors.forename: A
authors.initials: A
authors.lastname: Villers
authors.forename: A
authors.initials: A
authors.lastname: de La Taille
authors.forename: V
authors.initials: V
authors.lastname: Ficarra
authors.forename: M
authors.initials: M
authors.lastname: Crepel
authors.forename: R
authors.initials: R
authors.lastname: Bertini
authors.forename: L
authors.initials: L
authors.lastname: Salomon
authors.forename: G
authors.initials: G
authors.lastname: Verhoest
authors.forename: P
authors.initials: P
authors.lastname: Perrotte
authors.forename: K
authors.initials: K
authors.lastname: Bensalah
authors.forename: P
authors.initials: P
authors.lastname: Arjane
authors.forename: J
authors.initials: J
authors.lastname: Biserte
authors.forename: F
authors.initials: F
authors.lastname: Montorsi
authors.forename: P
authors.initials: P
authors.lastname: Karakiewicz
mesh_terms: D002292:Carcinoma, Renal Cell / Q000473:pathology / Q000601:surgery*; D005060:Europe; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000639:trends*