Resultados oncológicos y seguimiento en pacientes con cáncer renal localizado sometidos a nefrectomía parcial

Abstract

Background

Partial nephrectomy has become the standard surgical treatment for small renal masses under 7 cm, providing excellent oncologic and functional results.

Aim

To present the oncologic and functional results over a 10-year period in patients with stage cT1 lesions that underwent open or laparoscopic partial nephrectomy.

Material and methods

A retrospective, descriptive, observational study was conducted on 18 patients treated with partial nephrectomy within the time frame of 2005 to 2014. Surgery duration, surgical margins, and kidney function through scintigraphy and the R.E.N.A.L. score were analyzed.

Results

The mean follow-up period was 4.5 years and overall survival was 95.5%. Mean surgery duration was 3.2 h, 72.1% of the lesions were stage pT1a, the mean age of the patients was 61.7 years, and 16.7% of the cases presented with positive margins. Mean blood loss was 611 ml and 38.8% of the patients had a R.E.N.A.L. score of moderate complexity. There was only one death and it was not cancer-specific.

Discussion

Partial nephrectomy for small tumors is the treatment of choice. There was a 16% deterioration of kidney function with partial nephrectomy, results that are better than those reported in the literature for radical nephrectomy.

Conclusions

The results at 10 years were positive and the overall 10-year survival was determined by factors such as age, comorbidities, and the grade of cellular differentiation - not by the surgical technique. Our study suggests that partial nephrectomy performed by experienced surgeons provides adequate oncologic and functional results.