Partial and Radical Nephrectomy for Unilateral Synchronous Multifocal Renal Cortical XXXX .

@entity1 @entity8 @entity1625 @entity5 @entity1358 @entity703
OBJECTIVE: To evaluate clinicopathologic characteristics and treatment outcomes of @entity1 undergoing @entity1625 ( @entity1625 ) or radical nephrectomy (RN) for unilateral synchronous multifocal @entity703 . METHODS: We retrospectively reviewed medical records for 128 @entity1 with nonmetastatic, unilateral, synchronous, multifocal @entity703 who underwent surgical resection at our institution from 1995 to 2012. Five @entity1 with @entity1358 were excluded. Differences between @entity1 and @entity5 characteristics from the 2 nephrectomy groups were evaluated. Outcomes in terms of recurrence-free survival, overall survival, and chronic @entity8 upstaging were estimated using Kaplan-Meier methods. The log-rank test was used for group comparisons. RESULTS: The study cohort included 78 @entity1625 @entity1 (63%) and 45 RN @entity1 (37%); 17 of 95 planned @entity1625 (18%) were converted to RN. @entity5 diameter and RENAL nephrometry scores were greater in RN @entity1 (P <.0001 and P = .0002, respectively). Pathologic stage T3 was seen in 40% of RN @entity1 and 10% of @entity1625 @entity1 (P = .0002). Histologic concordance was apparent in 60 of 123 @entity1 (49%). Median follow-up for @entity1 alive without a recurrence was 4 years. Five-year recurrence-free survival was 98% for @entity1625 and 85% for RN. Five-year overall survival was 96% for @entity1625 and 86% for RN (P = .5). Five-year freedom from chronic @entity8 upstaging was 74% for @entity1625 and 55% for RN (P = .11). CONCLUSION: Partial nephrectomy for the treatment of unilateral, synchronous, multifocal, @entity703 with favorable characteristics was associated with a low recurrence rate. These findings suggest @entity1625 is an appropriate management strategy for this group of carefully selected @entity1 .
