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Comparison of Long-Term Renal Functions after Partial versus Radical Nephrectomy In a Turkish Patient Population with cT1 Renal Tumors: A Multicenter Study of the Urooncology Association, Turkey
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  • Volkan Izol,
  • Fatih Gokalp,
  • Sinan Sözen,
  • Ender Ozden,
  • Yıldırım Bayazıt,
  • Talha Muezzinoglu,
  • Önder Kara,
  • Serhat Çetin,
  • Murat Gülşen,
  • Levent Turkeri,
  • Mustafa Tansug
Volkan Izol
Cukurova University Faculty of Medicine
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Fatih Gokalp
Hatay Mustafa Kemal University
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Sinan Sözen
Gazi University
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Ender Ozden
Ondokuz Mayis Universitesi Tip Fakultesi
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Yıldırım Bayazıt
Çukurova Üniversitesi Tıp Fakültesi
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Talha Muezzinoglu
Celal Bayar University
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Önder Kara
Kocaeli Üniversitesi Tıp Fakültesi
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Serhat Çetin
Gazi Üniversitesi Tıp Fakültesi
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Murat Gülşen
Ondokuz Mayis Universitesi Tip Fakultesi
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Levent Turkeri
Acibadem University
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Mustafa Tansug
Cukurova University Faculty of Medicine
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Abstract

Abstract Purpose: To compare the functional outcomes of patients who underwent partial (PN) or radical nephrectomy (RN) for clinical T1 (cT1) renal tumors using the Kidney Cancer Database of the Urooncology Association, Turkey. Methods: We retrospectively reviewed 1004 patients who underwent PN and RN for cT1 renal tumors at multiple academic tertiary centers between 2000 and 2018. Patients with preoperative end-stage chronic kidney disease and/or metastatic disease were excluded. Results: There were 452 patients in the PN group and 552 patients in the RN group. The eGFR was significantly reduced in both groups on postoperative day one (PN=13.7 vs. RN=19.1 ml/min/1.73 m2: p<0.001). In the PN group, eGFR showed a tendency to recover according to a quadratic pattern and reached preoperative levels in the first and third years (95.6±28.8 ml/min/1.73 m2 and 96.9±28.9 ml/min/1.73 m2, respectively), with no significant difference between the eGFRs in the 1st and 3rd years (p=0.710). To define groups at risk, different cut-off values for the GFR were considered. Among patients with a baseline GFR<90, the RN cohort had significantly lower eGFRs in the first and third years than the PN cohort (p=0.02). Logistic regression showed that comorbidities, coronary artery disease, diabetes and hypertension had no adverse impacts on the changes in the eGFR (p=0.60, p=0.13, and p=0.13, respectively). Conclusion: For the treatment of stage T1 kidney tumors, the first choice should be open or laparoscopic partial nephrectomy due to the superior long-term preservation of renal function and overall survival, regardless of age and comorbidities.

Peer review status:ACCEPTED

22 Oct 2020Submitted to International Journal of Clinical Practice
25 Oct 2020Submission Checks Completed
25 Oct 2020Assigned to Editor
26 Oct 2020Reviewer(s) Assigned
04 Nov 2020Review(s) Completed, Editorial Evaluation Pending
24 Nov 20201st Revision Received
27 Nov 2020Assigned to Editor
27 Nov 2020Submission Checks Completed
27 Nov 2020Reviewer(s) Assigned
05 Dec 2020Review(s) Completed, Editorial Evaluation Pending
18 Dec 20202nd Revision Received
18 Dec 2020Submission Checks Completed
18 Dec 2020Assigned to Editor
18 Dec 2020Reviewer(s) Assigned
19 Dec 2020Review(s) Completed, Editorial Evaluation Pending
21 Dec 2020Editorial Decision: Accept