title: Partial versus radical nephrectomy for pT1a renal cancer in Serbia.
abstract: OBJECTIVE
  To assess the treatment outcome of pT1a renal tumors, comparing overall survival (OS) in patients treated with radical nephrectomy (RN) and partial nephrectomy (PN), and to examine the rate of utilization of PN in a tertiary institution in Serbia.
  
  
  METHODS
  Included were patients treated for pT1a kidney tumors with open RN or open PN during 1996-2013. The inclusion criterion was the pathological tumor stage T1a. Exclusion criteria were higher pathological stages, metastatic presentation, or imperative indications for partial nephrectomy. Patients were followed-up every 3 to 4 months for the first year after surgery, every 6 months until the 5th year, and annually thereafter.
  
  
  RESULTS
  286 patients were included in the study, and PN was performed in 177 (61.9%) of them, whereas RN was performed in the remaining 109 (38.1%). The median follow- up for the entire group was 42.0 months (interquartile range 74.5). There were no statistically significant differences between groups in cancer-specific survival (CSS) (log-rank=0.506; p=0.477). Patients selected for RN were more likely to be older, symptomatic at presentation, and have larger tumors. There was no statistically significant difference in OS between the two groups (log-rank=2.616; p=0.106). In 1996, 20% of the patients were treated with PN; this number increased to 88% in 2013.
  
  
  CONCLUSIONS
  We did not find OS advantage for PN compared to RN in the setting of a developing country. The use of PN is increasing and is now utilized for ∼90% of pT1a renal tumors.
authors.affiliation: Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Janicic
authors.forename: Uros
authors.initials: U
authors.lastname: Bumbasirevic
authors.forename: Tatjana
authors.initials: T
authors.lastname: Pekomezovic
authors.forename: Milica
authors.initials: M
authors.lastname: Cekerevac
authors.forename: Miodrag
authors.initials: M
authors.lastname: Acimovic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Dzamic
authors.forename: Cane
authors.initials: C
authors.lastname: Tulic
mesh_terms: D000368:Aged; D016208:Databases, Factual; D003906:Developing Countries; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009392:Nephrectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D012189:Retrospective Studies; D012307:Risk Factors; D055771:Serbia; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome