Partial nephrectomy versus ablative therapy for the treatment of renal tumors in an imperative setting
LONG, Jean-Alexandre
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Gestes Medico-chirurgicaux Assistés par Ordinateur [TIMC-IMAG-GMCAO]
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Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Gestes Medico-chirurgicaux Assistés par Ordinateur [TIMC-IMAG-GMCAO]
LONG, Jean-Alexandre
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Gestes Medico-chirurgicaux Assistés par Ordinateur [TIMC-IMAG-GMCAO]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Gestes Medico-chirurgicaux Assistés par Ordinateur [TIMC-IMAG-GMCAO]
LE CLERC, Quentin Come
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
Centre Hospitalier Universitaire de Nantes = Nantes University Hospital [CHU Nantes]
DESCOTES, Jean-Luc
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Gestes Medico-chirurgicaux Assistés par Ordinateur [TIMC-IMAG-GMCAO]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Gestes Medico-chirurgicaux Assistés par Ordinateur [TIMC-IMAG-GMCAO]
BENSALAH, Karim
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
< Réduire
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]
Langue
en
Article de revue
Ce document a été publié dans
World Journal of Urology. 2017-04, vol. 35, n° 4, p. 649 - 656
Springer Verlag
Résumé en anglais
Purpose - To compare partial nephrectomy (PN) and percutaneous ablative therapy (AT) for renal tumor in imperative indication of nephron-sparing technique (NST). Materials and methods - Between 2000 and 2015, 284 consecutive ...Lire la suite >
Purpose - To compare partial nephrectomy (PN) and percutaneous ablative therapy (AT) for renal tumor in imperative indication of nephron-sparing technique (NST). Materials and methods - Between 2000 and 2015, 284 consecutive patients with a kidney tumor in an imperative indication of NST were retrospectively included in a multicenter study. PN [open (n = 146), laparoscopic (n = 9), or robotic approach (n = 17)] and AT [radiofrequency ablation (n = 104) or cryoablation (n = 8)] were performed for solitary kidney (n = 146), bilateral tumor (n = 78), or chronic kidney disease (CKD) (n = 60). Results - Patients in the PN group had larger tumors and a higher RENAL score. There were no differences between the two groups with respect to age, reasons for imperative indication, and preoperative eGFR. Patients in the AT group had a higher ASA and CCI. PN had worse outcomes than AT in terms of transfusion rate, length of stay, and complication rate. Local radiological recurrence-free survival was better for PN, but metastatic recurrence was similar. Percentage of eGFR decrease was similar in the two groups. Temporary or permanent dialysis was not significantly different. On multivariate analysis, PN and AT had a similar eGFR change when adjusted for tumor complexity, reason of imperative indication and CCI. Conclusion - In imperative indication of nephron-sparing treatment for a kidney tumor, either PN or AT can be proposed. PN offers the ability to manage larger and more complex tumors while providing a better local control and a similar renal function loss.< Réduire
Mots clés en anglais
Renal cancer
Radiofrequency
Partial nephrectomy
Imperative indication
Cryoablation
Origine
Importé de halUnités de recherche