Conservative surgery not inferior to nephrectomy

The latest results from the European Organisation for Research and Treatment of Cancer (EORTC) 30904 study were presented in a plenary session today at the Anniversary EAU Congress, which showed that conservative surgery is not inferior to radical renal surgery or nephrectomy.

"Few patients progressed during the study, nine in the radical arm and 12 in the conservative arm," Prof. Hein van Poppel said in his concluding remarks. Van Poppel issued the EORTC results during the plenary session on kidney cancer, a study which examined partial versus radical nephrectomy in renal cancer.

The EORTC 30904 study involved 541 patients who were randomised, 273 in the radical arm and 268 treated with conservative surgery. Four patients were clinically ineligible, whilst 139 patients were pathologically ineligible. The median follow-up was around 9.3 years.

Amongst the study's pertinent findings were:

• Few patients progressed during the study, nine in the radical arm and 12 in the conservative arm
  
• 117 deaths

3 due to surgery: 1 in radical and 2 in conservative

• Overall survival (OS) is shorter on the conservative arm for all randomized patients (p=0.032)
  
• OS of RCC patients is not different (p=0.072)
  
• OS of Clinically and pathologically eligible patients is not different (p=0.173)
  
• Side effects: nephron-sparing surgery is safe with a slightly higher complication rate than after radical nephrectomy