Evaluation of surgical outcomes of nephron-sparing surgery in a leading hospital of an advanced nation

This is the authors' abstract. We don't add key points for this paper.

OBJECTIVE: To assess the efficacy of renal score grading in guiding therapy decisions, predicting perioperative outcomes, and characterising tumours following partial nephrectomy. METHODS: The retrospective, single-centre study was conducted at the University College Hospital Galway, Ireland, and comprised data from January 11, 2012, to June 17, 2016, of all patients aged >18 years who underwent partial nephrectomy as part of treatment for kidney cancer. Data was analysed using SPSS 20. RESULTS: Of the 76 patients, 52(68.4%) were males and 24(31.6%) were females. The median age of patients was 58 years (IQR: 16). Tumours were predominantly on the right side 44(57.9%) and lower pole 36(47.4%), with a median tumour size of 2.35 cm (IQR: 1.0 cm), and renal score had a median of 5.00 (IQR: 2). Of the total, 70(92.1%) patients underwent open surgery, with complications in 6(7.9%), which were associated significantly with higher body mass index, American Society of Anaesthesiologists classification score, warm ischaemia time and tumour size (p<0.05). Recurrence correlated with tumour size and positive margins (p<0.05). Survival analysis showed a median diseasefree survival (DFS) of 30 months (IQR: 6 months). However, due to the absence of events, the median overall survival (OS) and survival estimates could not be fully calculated. The longest follow-up time was 36 months, with no recorded mortality in the cohort. CONCLUSIONS: For individuals with comparatively small localised renal tumours, the selection of partial nephrectomy was found to be a suitable alternative, showcasing exceptional results regarding the complication profile, recurrencefree survival and overall survival.