Nephron sparing surgery has excellent lasting outcomes

(HealthDay)—For patients with bilateral renal masses, nephron sparing surgery (NSS) results in excellent long-term oncological and functional outcomes and survival rates, according to a study published in the December issue of The Journal of Urology.

Eric A. Singer, M.D., of the National Cancer Institute in Bethesda, Md., and associates reported outcomes for 128 patients who underwent NSS for bilateral renal masses and were followed for a minimum of 10 years (median, 16 years). Renal function and overall and renal cell carcinoma-specific survival were evaluated.

The researchers found that the patients underwent a median of three surgical interventions. At the last follow-up, 68 percent of the patients required repeat interventions at the ipsilateral renal unit, with a median of 6.2 years between interventions, and 4.7 percent of patients ultimately underwent bilateral nephrectomy. The overall survival was 88 percent, and renal cell cancer-specific survival was 97 percent. There was no difference in overall survival for patients with bilateral kidneys versus those with a surgically solitary kidney, although renal function was significantly better preserved for patients with two kidneys.

"At a minimum 10-year follow-up after initial surgery, NSS allowed for excellent oncological and functional outcomes," the authors write. "Despite the need for repeat surgical interventions, NSS enabled dialysis to be avoided in more than 95 percent of patients."

The study was partially supported by a grant from Pfizer to the Foundation of the National Institutes of Health.

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