title: Oncological outcomes and prognostic factors after nephron-sparing surgery in renal cell carcinoma.
abstract: OBJECTIVE
  To analyse the mid-term oncological results and to asses predictive factors for recurrence and survival after nephron-sparing surgery (NSS) for renal cell carcinoma.
  
  
  METHODS
  This is a retrospective study that includes 198 Partial Nephrectomies performed at our institution for malignant renal tumours. Demographic information and pathological characteristics were obtained, and completed statistical analysis was performed to assess predictors for overall survival (OS) and overall recurrence in our sample.
  
  
  RESULTS
  The presence of positive surgical margins (PSM) in the surgical specimen was reported in 13.6 %. At a median of follow-up of 56.1 months, the non-adjusted cancer-specific mortality, DSS and OS were 100, and 93.4 %, respectively. In the bivariate analysis regarding predictive factors for recurrence, bilaterality and NSS indication (elective or imperative) were statistically significant (p = 0.03 and p = 0.05 respectively). On multivariate analysis only bilaterality was a significant predictor of recurrence (p = 0.03), while high Fuhrman grade was for survival (p = 0.006).
  
  
  CONCLUSIONS
  Our data suggest that patients with bilateral tumours have a higher incidence of local recurrence. Regarding overall survival, our data showed more risk of death at 5 years in those patients with high Fuhrman grade. No differences were found among PSM and negative surgical margins patients regarding oncological outcomes.
authors: Department of Urology, Hospital Universitari de Bellvitge, University of Barcelona, 08907, Hospitalet de Llobregat, Barcelona, Spain. mlopez@bellvitgehospital.cat.
authors: Miguel Ángel
authors: MÁ
authors: López-Costea
authors: Department of Urology, Hospital Universitari de Bellvitge, University of Barcelona, 08907, Hospitalet de Llobregat, Barcelona, Spain.
authors: Xavier
authors: X
authors: Bonet
authors: Department of Urology, Hospital Universitari de Bellvitge, University of Barcelona, 08907, Hospitalet de Llobregat, Barcelona, Spain.
authors: Jose
authors: J
authors: Pérez-Reggeti
authors: Department of Urology, Hospital Universitari de Bellvitge, University of Barcelona, 08907, Hospitalet de Llobregat, Barcelona, Spain.
authors: Begoña
authors: B
authors: Etcheverry
authors: Department of Urology, Hospital Universitari de Bellvitge, University of Barcelona, 08907, Hospitalet de Llobregat, Barcelona, Spain.
authors: Francisco
authors: F
authors: Vigués
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000473:pathology* / Q000556:secondary / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007680:Kidney Neoplasms / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018365:Neoplasm, Residual; D009392:Nephrectomy / Q000379:methods; D009399:Nephrons / Q000601:surgery; D059351:Organ Sparing Treatments; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D055815:Young Adult
keywords: Nephron-sparing surgery; Recurrence; Renal cell carcinoma; Survival