title: Comparison of oncologic outcomes between partial and radical nephrectomy for localized renal cell carcinoma: A systematic review and meta-analysis.
abstract: To date, there remain uncertainties over the oncological outcomes for partial and radical nephrectomy of localized renal cell carcinoma (RCC). A systematic review and meta-analysis was performed. Eligible studies were retrieved from PubMed, Embase, Cochrane Library and Web of Science databases. The endpoints of oncologic outcomes included overall survival (OS), cancer-specific survival (CSS) and recurrence-free survival (RFS). Multivariable adjusted hazard ratios (HRs) were used to evaluate each endpoint. We used the Newcastle-Ottawa scale to assess risk of bias. Fourteen cohort studies of low to moderate risk of bias involving 28,764 patients were included. Adjusted variables and follow-up length varied between studies. The results showed that patients with localized RCC who underwent partial nephrectomy (PN) had a superior OS (HR: 0.81, 95% confidence interval (CI): 0.74-0.89; P < 0.001) compared with those underwent radical nephrectomy (RN). However, the CSS (HR: 0.85, 95% CI: 0.73-1.01; P = 0.060) and RFS (HR: 0.66, 95% CI: 0.34-1.31; P = 0.239) seem to be similar for patients underwent PN and RN. Most of subgroup analyses according to year of publication, patient population, geographic region and NOS score did not alter the direction of results. PN for localized RCC is associated with better OS, similar CSS and RFS compared with RN based on observational data with low to moderate risk of bias. Methodological limitations of the observational studies included should be considered while interpreting these results.
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Liangyou
authors.initials: L
authors.lastname: Gu
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Xin
authors.initials: X
authors.lastname: Ma
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Hongzhao
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Luyao
authors.initials: L
authors.lastname: Chen
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China; School of Medicine, Nankai University, Tianjin, China.
authors.forename: Yongpeng
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Xintao
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Urology/State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, China. Electronic address: xzhang@tjh.tjmu.edu.cn.
authors.forename: Xu
authors.initials: X
authors.lastname: Zhang
mesh_terms: D002292:Carcinoma, Renal Cell / Q000601:surgery*; D006801:Humans; D007680:Kidney Neoplasms / Q000601:surgery*; D009392:Nephrectomy / Q000401:mortality*; D018426:SEER Program; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Localized; Meta-analysis; Partial nephrectomy; Radical nephrectomy; Renal cell carcinoma; Survival