Simple enucleation is equivalent to traditional partial nephrectomy for XXXX : results of a nonrandomized, retrospective, comparative study.

@entity1 @entity1358 @entity5 @entity703
PURPOSE: The excision of the @entity703 with a substantial margin of healthy parenchyma is considered the gold standard technique for partial nephrectomy. However, simple enucleation showed excellent results in some retrospective series. We compared the oncologic outcomes after standard partial nephrectomy and simple enucleation. MATERIALS AND METHODS: We retrospectively analyzed 982 @entity1 who underwent standard partial nephrectomy and 537 who had simple enucleation for localized @entity1358 at 16 academic centers between 1997 and 2007. Local recurrence, @entity5 specific survival and progression-free survival were the main outcomes of this study. The Kaplan-Meier method was used to calculate survival functions and differences were assessed with the log rank statistic. Univariable and multivariable Cox regression models addressed progression-free survival and @entity5 specific survival. RESULTS: Median followup of the @entity1 undergoing traditional partial nephrectomy and simple enucleation was 51    37.8 and 54.4    36 months, respectively (p = 0.08). The 5 and 10-year progression-free survival estimates were 88.9 and 82% after standard partial nephrectomy, and 91.4% and 90.8% after simple enucleation (p = 0.09). The 5 and 10-year @entity5 specific survival estimates were 93.9% and 91.6% after standard partial nephrectomy, and 94.3% and 93.2% after simple enucleation (p = 0.94). On multivariable analysis the adopted nephron sparing surgery technique was not an independent predictor of progression-free survival (HR 0.8, p = 0.55) and @entity5 specific survival (HR 0.7, p = 0.53) when adjusted for the effect of the other covariates. CONCLUSIONS: To our knowledge this is the first multicenter, comparative study showing oncologic equivalence of standard partial nephrectomy and simple enucleation.
