Open partial nephrectomy for renal cell cancer in a medium patient volume centre: is high quality possible?
OBJECTIVE
To describe the surgical complication rate of open partial nephrectomy (OPN) in patients with renal tumours, and to report the oncological long-term outcome in unilateral renal cell cancer patients subjected to this procedure, from a medium patient volume urological centre.


METHODS
Data from all patients (n = 89) subjected to OPN for proven or suspected renal cell cancer during the period 1965-2007 were registered in a specifically designed database system. Tumour stage and size, surgical margin, histology, perioperative and postoperative complications were analysed in all patients. In addition, long-term follow-up outcomes in malignant unilateral tumours (n = 51) were analysed.


RESULTS
Seventy-four of the resected tumours were malignant. Six of these had a positive surgical margin; five from patients with multifocal or bilateral tumours and one from a patient with a solitary malignant cyst. Perioperative complications were registered in only one case (1%). Postoperative complications (within 30 days postoperatively) reached 18%. The long-term follow-up (mean 79 months, median 49 months, range 14 months to 26 years) in patients with unilateral malignant tumours, all staged T1-T2, revealed two systemic recurrences, both in patients with poor prognostic markers at the time of surgery, but no local recurrence.


CONCLUSIONS
OPN has complication rates similar to open radical nephrectomy. Long-term tumour control in unilateral cases and with organ confined disease is excellent. The results demonstrate that carefully performed OPN at a medium-volume centre can achieve equal results to high-volume centres.
Forsberg
Annika Mandahl
AM
Department of Urology, Skåne University Hospital, Malmö, Sweden.
Uvelius
Bengt
B
Wullt
Björn
B
D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D053208:Kaplan-Meier Estimate; D007668:Kidney / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000592:standards; D008137:Longitudinal Studies; D019060:Minimally Invasive Surgical Procedures / Q000592:standards; D009392:Nephrectomy / Q000379:methods*; D011787:Quality of Health Care / Q000592:standards*; D012189:Retrospective Studies; D016896:Treatment Outcome