title: Nephron sparing surgery for De Novo kidney graft tumor: results from a multicenter national study.
abstract: Nephron sparing surgery (NSS) results in the transplanted population remain unknown because they are only presented in small series or case reports. Our objective was to study renal sparing surgery for kidney graft renal cell carcinomas (RCC) in a multicenter cohort. Data were collected from 32 French transplantation centers. Cases of renal graft de novo tumors treated as RCC since the beginning of their transplantation activity were included. Seventy-nine allograft kidney de novo tumors were diagnosed. Forty-three patients (54.4%) underwent renal sparing surgery. Mean age of grafted kidneys at the time of diagnosis was 47.5 years old (26.1-72.6). The mean time between transplantation and tumor diagnosis was 142.6 months (12.2-300). Fifteen tumors were clear cell carcinomas (34.9%), and 25 (58.1%) were papillary carcinomas. Respectively, 10 (24.4%), 24 (58.3%) and 8 (19.5%) tumors were Fuhrman grade 1, 2 and 3. Nine patients had postoperative complications (20.9%) including four requiring surgery (Clavien IIIb). At the last follow-up, 41 patients had a functional kidney graft, without dialysis and no long-term complications. NSS is safe and appropriate for all small tumors of transplanted kidneys with good long-term functional and oncological outcomes, which prevent patients from returning to dialysis.
authors.affiliation: Department of Urology, CHU de Caen, France.
authors.forename: X
authors.initials: X
authors.lastname: Tillou
authors.forename: K
authors.initials: K
authors.lastname: Guleryuz
authors.forename: A
authors.initials: A
authors.lastname: Doerfler
authors.forename: H
authors.initials: H
authors.lastname: Bensadoun
authors.forename: D
authors.initials: D
authors.lastname: Chambade
authors.forename: R
authors.initials: R
authors.lastname: Codas
authors.forename: M
authors.initials: M
authors.lastname: Devonec
authors.forename: F
authors.initials: F
authors.lastname: Dugardin
authors.forename: A
authors.initials: A
authors.lastname: Erauso
authors.forename: J
authors.initials: J
authors.lastname: Hubert
authors.forename: G
authors.initials: G
authors.lastname: Karam
authors.forename: L
authors.initials: L
authors.lastname: Salomon
authors.forename: C
authors.initials: C
authors.lastname: Sénéchal
authors.forename: F
authors.initials: F
authors.lastname: Salusto
authors.forename: N
authors.initials: N
authors.lastname: Terrier
authors.forename: M O
authors.initials: MO
authors.lastname: Timsit
authors.forename: R
authors.initials: R
authors.lastname: Thuret
authors.forename: G
authors.initials: G
authors.lastname: Verhoest
authors.forename: F
authors.initials: F
authors.lastname: Kleinclauss
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000601:surgery*; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D007680:Kidney Neoplasms / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D009399:Nephrons; D016896:Treatment Outcome
chemical_list: D007166:Immunosuppressive Agents
keywords: Clinical research; kidney disease; kidney transplantation; malignancy; malignant; neoplasia; nephrology; practice; surgical technique; urology cancer