Renal functional outcome after nephron sparing treatment of renal cell carcinoma: a systematic review

Pia Iben Pietersen, Louise Aarup Duus, Theresa Junker, Lars Lund, Benjamin Schnack Rasmussen, Ole Graumann

Research output: Contribution to conferencePosterResearchpeer-review

Abstract

Background: The incidence of renal cell carcinomas increases, and the treatment continuous to evolve.
Purpose: To explore renal functional outcome after laparoscopic partial nephrectomy (LPN), robotic assisted
partial nephrectomy (RAPN), and computed tomography (CT)-guided cryoablation for T1 renal cell
carcinoma.
Materials and methods: A systematic search was conducted in OVID Medline, Embase, and Cochrane
Library, May 2021. Inclusion criteria: Reporting baseline and 3 months posttreatment renal function after
LPN, RAPN, or cryoablation for T1 renal cell carcinoma. Exclusion criteria: Ischemic time >30 minutes and
LPN and RAPB performed before 2010. Quality assessment was performed with a modified New Castle
Ottawa Scale by two independent assessors.
Results: The search yielded 4,875 studies. In total, 434 studies were full text screened, 42 studies were
included. Total 2,829 patients were treated and data from 1,542 LPN, 721 RAPN, and 566 cryoablation were
analysed. Compiled eGFR reduction divided by treatment type were -7.08±5.07 mL/min/1.73m2 for RAPN, -
7.60±3.23 mL/min/1.73m2 for LPN, and -4.28 ±5.96 mL/min/1.73m2 for cryoablation and were nonsignificant within nor between the groups using one-way ANOVA, p=0.242. Mean tumour size was almost
equal; 31.9±6.3 mm for RAPN, 32.7±9.3 mm for LPN, and 31.4±9.1 mm for cryoablation, and RENAL
nephrometry score not statistical different. Quality assessments were highest among RAPN studies, 5.0±2.5
stars versus 4.7±1.9 for LPN and 3.7±1.0 for cryoablation studies.
Conclusion: This review with only three RCT indicates that both LPN, RAPN, and cryoablation for T1 renal
cell carcinoma have a high renal functional preservation with no significant difference between the
reduction.
Original languageEnglish
Publication date9 Jun 2022
Publication statusPublished - 9 Jun 2022
Externally publishedYes
EventNordisk Urologisk Forum 2022 - Helsinki, Finland
Duration: 8 Jun 202211 Jun 2022
http://www.nuf2021.fi/

Conference

ConferenceNordisk Urologisk Forum 2022
Country/TerritoryFinland
CityHelsinki
Period08/06/202211/06/2022
Internet address

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