Partial nephrectomy does not compromise survival in @entity1 with pathologic upstaging to pT2/ XXXX or high-grade @entity703 compared with radical nephrectomy.

@entity1 @entity1803 @entity1625 @entity7487 @entity5 @entity1358 @entity1349 @entity703
OBJECTIVE: To compare survival in @entity1 with clinical T1b @entity703 that are pathologically upstaged, or high-grade @entity5 , treated by either @entity1625 ( @entity1625 ) or radical nephrectomy (RN). The American Urological Association Guidelines recently advocated increasing use of @entity1625 in all @entity1 with @entity7487 renal masses, but urologists are often hesitant to perform @entity1625 for larger more aggressive appearing @entity7487 @entity703 for fear of pathologic upstaging and a perceived compromise in @entity5 control. METHODS: From a single institutional @entity703 registry, 2511 consecutive @entity1 with presumed @entity7487 @entity1358 underwent extirpative surgery; 1981 (79%) were found to have @entity1358 ( @entity1358 ) and 213 (10.7%) were upstaged on final pathology. In addition, 95 (5%) were found to have grade 4 @entity5 . Cancer-specific survival (CS) and @entity1349 ( @entity1349 ) were compared between the groups. RESULTS: In the upstaged cohort, @entity1 treated by @entity1625 (n = 96, 45%) had comparable @entity1349 and CS when studied stage for stage with those treated by RN (n = 117, 55%). Multivariate cox-proportional hazards analysis of @entity1349 in the upstaged subset demonstrated that only age, grade, and Charlson score predicted @entity1349 , whereas @entity1625 vs RN and stage did not. @entity1625 did not compromise survival in @entity1 with grade 4 @entity1358 compared with RN. CONCLUSIONS: @entity1625 does not appear to compromise the chance for @entity5 cure in @entity1 with @entity7487 @entity5 that are upstaged pathologically to pT2 or @entity1803 or high-grade renal masses when compared with RN. These concerns should not deter a surgeon from attempting @entity1625 when otherwise technically feasible.
