title: The use of partial nephrectomy: results from a contemporary national prospective multicenter study.
abstract: OBJECTIVE
  Despite benefits in functional renal outcome and favorable oncological efficacy, previous studies show marked underuse of partial nephrectomy (PN). We investigated national utilization of partial and radical nephrectomy (RN) using a contemporary, prospective population-based cohort.
  
  
  METHODS
  Between June and December 2010, 1,237 patients were treated by PN or RN for renal cell carcinoma in 56 French centers. Data were prospectively collected, and statistical analyses were performed.
  
  
  RESULTS
  Overall, 667 (53.9 %) and 570 patients (46.1 %) underwent RN and PN, respectively. In case of PN, surgical approach was an open PN in 63.3 % of cases, a laparoscopic PN in 21.0 % of cases and a robot-assisted PN in 15.7 % of cases. PN was used in T1a, T1b, T2 and T3 tumors in 395 (76.7 %), 131 (38.2 %), 29 (14.7 %) and 7 (4.6 %), respectively. Median ischemia time was 16 min [0-60], and mean blood loss was 280.4 ml (±339.9). Tumor characteristics and operative features were significantly different according to the surgical approach. Warm ischemia time was significantly higher in case of laparoscopic or robot-assisted procedure (p < 0.001). There was no statistical significant difference in blood loss and transfusion rate according to surgical approach. Postoperative medical and surgical complications occurred in 8.2 and 10.0 % of PN, respectively, with no significant difference according to surgical approach.
  
  
  CONCLUSIONS
  Partial nephrectomy for renal cell carcinoma is commonly used in this French centers sample. Mini-invasive approaches represent also a significant part of all partial nephrectomies with no difference in terms of complication rates.
authors.affiliation: Department of Urology, Bicetre Hospital, Paris XI University, 78 rue du General Leclerc, 94275, Le Kremlin Bicêtre Cedex, France, gg_pignot@yahoo.fr.
authors.forename: Géraldine
authors.initials: G
authors.lastname: Pignot
authors.forename: Arnaud
authors.initials: A
authors.lastname: Méjean
authors.forename: Jean-Christophe
authors.initials: JC
authors.lastname: Bernhard
authors.forename: Pierre
authors.initials: P
authors.lastname: Bigot
authors.forename: Marc-Olivier
authors.initials: MO
authors.lastname: Timsit
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Ferriere
authors.forename: Marc
authors.initials: M
authors.lastname: Zerbib
authors.forename: Arnauld
authors.initials: A
authors.lastname: Villers
authors.forename: Pascal
authors.initials: P
authors.lastname: Mouracade
authors.forename: Hervé
authors.initials: H
authors.lastname: Lang
authors.forename: Karim
authors.initials: K
authors.lastname: Bensalah
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Couapel
authors.forename: Jerome
authors.initials: J
authors.lastname: Rigaud
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Laurent
authors.initials: L
authors.lastname: Bellec
authors.forename: Michel
authors.initials: M
authors.lastname: Soulié
authors.forename: Christophe
authors.initials: C
authors.lastname: Vaessen
authors.forename: Morgan
authors.initials: M
authors.lastname: Roupret
authors.forename: Hervé
authors.initials: H
authors.lastname: Baumert
authors.forename: Pierre
authors.initials: P
authors.lastname: Gimel
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Patard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D005602:France; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000706:statistics & numerical data*; D061646:Operative Time; D011446:Prospective Studies; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data*; D016896:Treatment Outcome; D052096:Warm Ischemia; D055815:Young Adult