Fiche publication
Date publication
juin 2009
Auteurs
Membres identifiés du Cancéropôle Est :
Pr JACQMIN Didier
,
Pr LANG Hervé
Tous les auteurs :
Jeldres C, Patard JJ, Capitanio U, Perrotte P, Suardi N, Crepel M, Ficarra V, Cindolo L, de La Taille A, Tostain J, Pfister C, Albouy B, Colombel M, Mejean A, Lang H, Jacqmin D, Bernhard JC, Ferriere JM, Bensalah K, Karakiewicz PI
Lien Pubmed
Résumé
OBJECTIVES: To assess cancer-specific survival of partial nephrectomy (PN) patients with >or= 7-cm lesions or unfavorable pathology (stage T3a or Fuhrman grades III-IV). MATERIAL AND METHODS: At 13 participation centers, 4072 partial or radical nephrectomies (RN) were performed for RCC between 1984 and 2001. Of all procedures, 925 (22.7%) were for tumors > 7 cm, 973 (23.9%) had Fuhrman grades III or IV, and 861 (21.1%) had stage pT3a. None had nodal or distant metastases. Matched (age, gender, tumor size, T stage, histologic subtype, and Fuhrman grade [FG]) survival analyses addressed the effect of nephrectomy type (partial vs radical) on cancer-specific mortality. RESULTS: Partial nephrectomy for tumors > 7 cm was associated with higher mortality than RN (HR = 5.3; P = .025). No significant cancer-specific survival differences were recorded after PN for FG III-IV (HR = 0.7, P = .5) or for pT3a lesions (HR = 2.5, P = .9). CONCLUSIONS: Partial nephrectomy may undermine cancer control in patients with tumors > 7 cm. Conversely, after PN, the same cancer control rates as after RN may be expected in patients with Fuhrman grades III-IV or with pT3a histology.
Référence
Urology. 2009 Jun;73(6):1300-5
