A new study reports that selected patients with short life expectancy can safely undergo partial nephrectomy with perioperative outcomes that approximate those of patients with long life expectancy. The authors suggest that extensive centre and/or surgeon experience, a robot-assisted approach, and off-clamp and simple enucleation techniques might facilitate favourable outcomes in these challenging patients.
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References
Campbell, S. C. et al. Renal mass and localized renal cancer: AUA Guideline. J. Urol. 198, 520–529 (2017).
Larcher, A. et al. Elective nephron sparing surgery decreases other cause mortality relative to radical nephrectomy only in specific subgroups of patients with renal cell carcinoma. J. Urol. 196, 1008–1013 (2016).
Van Poppel, H. et al. A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma. Eur. Urol. 59, 543–552 (2011).
Campbell, S. C., Demirjian, S., Zhang, Z. & Mishra, K. Renal function after renal cancer surgery. AUA Update Series 24 (Lesson 23), 216–223 (2015).
Gontero, P. et al. Is partial nephrectomy safe and effective in the setting of frail comorbid patients affected by renal cell carcinoma? Insights from the RECORD 2 multicenter prospective study. Urol. Oncol. https://doi.org/10.1016/j.urolonc.2020.09.022 (2020).
Marconi, L. et al. Systematic review and meta-analysis of diagnostic accuracy of percutaneous renal tumour biopsy. Eur. Urol. 69, 660–673 (2016).
Ljungberg, B. et al. European Association of Urology Guidelines on renal cell carcinoma: the 2019 update. Eur. Urol. 75, 799–810 (2019).
Gill, I. S. et al. Comparison of 1,800 laparoscopic and open partial nephrectomies for single renal tumors. J. Urol. 178, 41–46 (2007).
Bove, P. et al. Deviation from the protocol of a randomized clinical trial comparing on-clamp versus off-clamp laparoscopic partial nephrectomy (CLOCK II Laparoscopic Study): a real-life analysis. J. Urol. https://doi.org/10.1097/JU.0000000000001417 (2020).
Wu, J. et al. Vascularized parenchymal mass preserved with partial nephrectomy: functional impact and predictive factors. Eur. Urol. Oncol. 2, 97–103 (2019).
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Campbell, S.C., Campbell, R.A. Partial nephrectomy for patients with limited life expectancy?. Nat Rev Urol 18, 193–194 (2021). https://doi.org/10.1038/s41585-020-00421-5
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DOI: https://doi.org/10.1038/s41585-020-00421-5