Cancer control of partial nephrectomy for high-risk localized XXXX : population-based and single-institutional analysis.

@entity1 @entity66 @entity6841 @entity5 @entity14318 @entity1358 @entity1349
PURPOSE: Cancer control of partial nephrectomy for high-risk localized @entity1358 is unclear. To assess whether @entity6841 provides adequate @entity5 control in @entity66 ( @entity14318 ), survival outcomes were compared in both a population-based cohort and an institutional cohort. METHODS: Surveillance, Epidemiology, and End Results database and a prospectively maintained institutional database were queried for @entity1 with @entity1358 who underwent @entity6841 or RN for a localized @entity5  <=7  cm and were found to have @entity14318 ( @entity14318 ). Cancer-specific (CSS) or @entity1349 ( @entity1349 ) and @entity1349 ( @entity1349 ) were primary outcomes measured and were compared between those who underwent @entity6841 and RN using multivariable Cox proportional hazards and propensity analysis. RESULTS: The population cohort consisted of 12,757 (24.9  %) @entity1 with @entity14318 , 85.2 and 14.8  % of which underwent RN and @entity6841 , respectively. RN was not associated with CSS (HR 1.23, p  =  0.08) but was independently associated with poor @entity1349 (HR 1.16, p  =  0.031). Propensity analysis showed that RN resulted in a 20  % increased risk of death from all causes (p  =  0.008). In the institutional cohort, of 317 @entity1 , 35.9  % had @entity14318 , 56 and 52 of which underwent RN and @entity6841 , respectively. Adjusting for age-adjusted Charlson index, RN was a predictor of poor @entity1349 (OR 6.20, p  =  0.041). Propensity analysis showed that @entity1349 and @entity1349 were not related to nephrectomy type (RN HR 0.65, p  =  0.627 and RN HR 1.70, p  =  0.484). CONCLUSIONS: In @entity1 with pathologic high-risk @entity1358 , partial excision is associated with similar @entity5 control as compared to radical excision.
