Partial nephrectomy for T1 XXXX can achieve an equivalent oncological outcome to radical nephrectomy with better renal preservation: the way to go.

@entity1 @entity8 @entity5 @entity740 @entity703
INTRODUCTION: @entity1 who undergo partial nephrectomy have been shown to be at decreased risk of @entity8 compared with radical nephrectomy. We examined the oncological outcome of @entity1 in our centre who underwent partial or radical nephrectomy for T1 @entity703 (7 cm or smaller), and compared the likelihood of developing @entity740 . METHODS: This historical cohort study with internal comparison was conducted in a tertiary hospital in Hong Kong. A cohort of 86 @entity1 with solitary T1 @entity703 and a normal contralateral kidney who underwent radical (38 @entity1 ) or partial (48 @entity1 ) nephrectomy between January 2005 and December 2010 was included. The overall and @entity5 -free survival, change in glomerular filtration rate, and new onset of @entity740 were compared between the radical and partial nephrectomy groups. RESULTS: A total of 32 (84%) radical nephrectomy @entity1 and 43 (90%) partial nephrectomy @entity1 were alive by 31 December 2012. The mean follow-up was 43.5 (standard deviation, 22.4) months. There was no significant difference in overall survival (P=0.29) or @entity5 -free survival (P=0.29) between the two groups. Both groups enjoyed good oncological outcome with no recurrence in the partial nephrectomy group. Overall, 18 (21%) @entity1 had pre-existing @entity740 . The partial nephrectomy group had a significantly smaller median reduction in glomerular filtration rate (12.6% vs 35.4%; P<0.001), and radical nephrectomy carried a significantly higher risk of developing @entity740 (hazard ratio=5.44; 95% confidence interval, 1.26-23.55; P=0.02). CONCLUSIONS: Compared with radical nephrectomy, partial nephrectomy can prevent @entity740 and still achieve an excellent oncological outcome for @entity703 , in particular T1a @entity5 and @entity5 with a low R.E.N.A.L. score.
