Functional outcomes of nephron-sparing surgery for renal cell carcinoma T1b–T2 stage


  • V.M. Grygorenko State Institution «Institute of urology NAMS of Ukraine», Ukraine
  • A.P. Onyshchuk Volynian Regional Clinical Hospital, Ukraine
  • M.V. Vikarchuk State Institution «Institute of urology NAMS of Ukraine», Ukraine
  • R.O. Danylets State Institution «Institute of urology NAMS of Ukraine», Ukraine
  • A.P. Nesterchuk State Institution «Institute of urology NAMS of Ukraine», Ukraine
  • O.O. Banas State Institution «Institute of urology NAMS of Ukraine», Ukraine
  • L.V. Pereta State Institution «Institute of urology NAMS of Ukraine», Ukraine



renal cell carcinoma, partial nephrectomy, renal function


Aim. To compare the functional outcomes of radical nephrectomy (NE) and partial nephrectomy (PN) in patients with T1b-T2 renal cell carcinoma (RCC). Materials and methods. A retrospective assessment of the functional results of 167 patients with RCC clinical stage T1b-T2N0M0, which were operated in period from 2012 to 2015 were done. PN was performed in 79 patients (47.0%), NE – 88 (53.0%). Functional results were evaluated by determining the rate of glomerular filtration (GFR) using the Cockroft–Holt’s formula. Results. In the PN and NE group, the GFR before surgery was 99.3 and 93.4 ml/min/1.73 m2 (p=0.284), after 7 days 86.3 and 76.5 ml/min/1.73 m2 (p=0.021), after 1 year after surgery 82.1 and 70.1 ml/min/1.73 m2 (p=0.0003), respectively. 1 After 1 year after surgery GFR decreased in the group of PN by 13.0%, in the group of NE – by 21.4% (p = 0.003). Also, after NE, the number of patients with III–IV stage of chronic kidney disease (CKD) increased by 21.2% (p=0.0023), after PN – did not change. Conclusions. Retrospective evaluation of functional results of surgical treatment of T1b-T2 RCC in the early postoperative period and 1 year after surgery demonstrated that PN provides better preservation of functional renal parenchyma and renal function, as well as a decrease of the number of patients with clinically significant CKD, compared to NE.


Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J., Jemal A. Global cancer statistics 2012 // CA Cancer J Clin. – 2015;65:87–108.

Ljungberg B., Campbell S.C., Choi H.Y. et al. The epidemiology of renal cell carcinoma // Eur Urol. – 2011;60:615–621.

Robson C.J., Churchill B.M., Anderson W. The results of radical nephrectomy for renal cell carcinoma // J Urol. – 1969;101:297.

Uzzo R.G., Novick A.C. Nephron sparing surgery for renal tumors: indications, techniques and outcomes // J Urol. – 2001;166:6–18.

Huang W.C., Levey A.S., Serio A.M. et al. Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study // Lancet Oncol. – 2006;7:735–740.

Zini L., Perrotte P., Capitanio U. et al. Radical versus partial nephrectomy: effect on overall and non cancer mortality // Cancer. – 2009;115:1465–1471.

Miller D.C., Schonlau M., Litwin M.S., Lai J., Saigal C.S. Renal and cardiovascular morbidity after partial or radical nephrectomy // Cancer. – 2008;112:511–520.

Ljungberg B., Bensalah K., Canfield S., Dabestani S., Hofmann F., Hora M. et al. EAU guidelines on renal cell carcinoma: 2014 update // Eur Urol. – 2015;67:913–24. Doi: 10.1016/j.eururo.2015.01.005.

Campbell S.C., Novick A.C., Belldegrun A., Blute M., Chow G., Derweesh I.H. et al. Guideline for management of the clinical T1 renal mass // J Urol. – 2009;182:1271–9. Doi: 10.1016/j.juro.2009.07.004.

Lee H.J., Liss M.A., Derweesh I.H. Outcomes of partial nephrectomy for clinical T1b and T2 renal tumors // Curr Opin Urol. – 2014;24:448–52. Doi: 10.1097/MOU.0000000000000081.

Mir M.C., Derweesh I., Porpiglia F., Zargar H., Mottrie A., Autorino R. Partial Nephrectomy Versus Radical Nephrectomy for Clinical T1b and T2 Renal Tumors: A Systematic Review and Meta-analysis of Comparative Studies // Eur Urol. – 2017;71:606–617. Doi: 10.1016/j.eururo.2016.08.060.

Weight C.J., Miller D.C., Campbell S.C., Derweesh I.H., Lane B.R., Messing E.M. The management of a clinical T1b renal tumor in the presence of a normal contralateral kidney // J Urol. – 2013;189:1198–202. Doi: 10.1016/j.juro.2013.01.030.

Creґpel M., Jeldres C., Perrotte P., Capitanio U., Isbarn H., Shariat S.F. et al. Nephron-sparing surgery is equally effective to radical nephrectomy for T1BN0M0 renal cell carcinoma: a population-based assessment // Urology. – 2010;75:271–5. Doi: 10.1016/j.urology.2009.04.098.

Badalato G.M., Kates M., Wisnivesky J.P., Choudhury A.R., McKiernan J.M. Survival after partial and radical nephrectomy for the treatment of stage T1bN0M0 renal cell carcinoma (RCC) in the USA: a propensity scoring approach // BJU Int. – 2012;109:1457–62. Doi: 10.1111/j.1464-410X.2011.10597.x.

Hadjipavlou M., Khan F., Fowler S., Joyce A., Keeley F.X., Sriprasad S. Partial vs radical nephrectomy for T1 renal tumours: an analysis from the British Association of Urological Surgeons Nephrectomy Audit // BJU Int. – 2016;117:62–71.

Meskawi M., Becker A., Bianchi M. et al. Partial and radical nephrectomy provide comparable long-term cancer control for T1b renal cell carcinoma // Int J Urol. – 2014;21:122–8. Doi: 10.1111/bju.13114.

Brierley J.D., Gospodarowicz M.K., Wittekind C. TNM classification of malignant tumors. UICC International Union Against Cancer. 8th edn. – Wiley-Blackwell, 2017. – 241 p.

Levey A.S., de Jong P.E., Coresh J. et al. The definition, classification, and prognosis of chronic kidney disease: a KDIGO Controversies Conference report // Kidney international. – 2011;80(1):17–28.

V.М. Grygorenko, А.P. Оnyshchuk, М.V. Vikarchuk, R.О. Danylets, А.P. Nesterchuk, О.О. Banas, L.V. Pereta. Порівняння онкологічних результатів нефректомії та резекції нирки у лікуванні хворих із раком нирки стадій T1B та T2 // Klinichna khirurhiia. – 2018;85(3):48–51. Doi: 10.26779/2522 1396.2018.03.48.

Frank I., Blute M.L., Cheville J.C., Lohse C.M., Weaver A.L. Solid renal tumors: an analysis of pathological features related to tumor size // J Urol. – 2003;170:2217–2220.

Joniau S., Vander Eeckt K., Srirangam S.J., Van Poppel H. Outcome of nephron-sparing surgery for T1b renal cell carcinoma // BJU Int. – 2009;103:1344–1348.

Weight C.J., Lieser G., Larson B.T. et al. Partial nephrectomy is associated with improved overall survival compared to radical nephrectomy in patients with unanticipated benign renal tumours // Eur Urol. – 2010;58:293–298.

Huang W.C., Elkin E.B., Levey A.S., Jqng T.L., Russo P. Partial nephrectomy versus radical nephrectomy in patients with small renal tumors – is there a difference in mortality and cardiovascular outcomes? // The Journal of urology. – 2009;181(1):55–61.

Lesage K., Joniau S., Fransis K., Van Poppel H. Comparison between open partial and radical nephrectomy for renal tumours: perioperative outcome and health-related quality of life // European urology. – 2007;51(3):614–20.