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Review Comparison of the oncological, perioperative and functional outcomes of partial nephrectomy versus radical nephrectomy for clinical T1b renal cell carcinoma: A systematic review and meta-analysis of retrospective studies

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收录情况: ◇ CSCD-C ◇ 卓越:梯队期刊 ◇ ESCI

单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Urol,Tongji Med Coll,Wuhan,Peoples R China [2]Huazhong Univ Sci & Technol,Hubei Inst Urol,Tongji Hosp,Tongji Med Coll,Wuhan,Peoples R China [3]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Geriatr,Tongji Med Coll,Wuhan,Peoples R China
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关键词: Kidney cancer Partial nephrectomy Radical nephrectomy Renal cancer Survival Renal function

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Objective: To conduct a meta-analysis assessing the perioperative, functional and oncological outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) for T1b tumours. The primary endpoints were the oncological outcomes. The secondary endpoints were the perioperative and functional outcomes. Methods: A systematic literature review was performed by searching multiple databases through February 2019 to identify eligible comparative studies according to the Preferred Reporting Items for Systematic Review and Meta-analysis statement. Identified reports were assessed according to the Newcastle-Ottawa Scale for nonrandomized controlled trials. Results: Overall, 13 retrospective cohort studies were included in the analysis. Patients undergoing PN were younger (weighted mean difference [WMD] -3.49 years, 95% confidence interval [CI] -5.16 to -1.82; p<0.0001) and had smaller masses (WMD -0.45 cm, 95% CI -0.59 to - 0.31; p<0.0001). There were no differences in the oncological outcome, which was demonstrated by progression-free survival (hazard ratio [HR] 0.70; p=0.22), cancer-specific mortality (HR 0.91; p=0.57) and all-cause mortality (HR 1.01; p=0.96). The two procedures were similar in estimated blood loss (WMD - 16.47 mL; p=0.53) and postoperative complications (risk ratio [RR] 1.32; pZ0.10), and PN provided better renal function preservation and was related to a lower likelihood of chronic kidney disease onset (RR 0.38; p=0.006). Conclusion: PN is an effective treatment for T1b tumours because it offers similar surgical morbidity, equivalent cancer control, and better renal preservation compared to RN. (C) 2021 Editorial Office of Asian Journal of Urology. Production and hosting by Elsevier B.V.

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大类 | 3 区 医学
小类 | 3 区 泌尿学与肾脏学
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出版当年[2019]版:
最新[2023]版:
Q2 UROLOGY & NEPHROLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版]

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第一作者单位: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Urol,Tongji Med Coll,Wuhan,Peoples R China [2]Huazhong Univ Sci & Technol,Hubei Inst Urol,Tongji Hosp,Tongji Med Coll,Wuhan,Peoples R China [3]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Geriatr,Tongji Med Coll,Wuhan,Peoples R China
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通讯机构: [1]Huazhong Univ Sci & Technol,Tongji Hosp,Dept Urol,Tongji Med Coll,Wuhan,Peoples R China [2]Huazhong Univ Sci & Technol,Hubei Inst Urol,Tongji Hosp,Tongji Med Coll,Wuhan,Peoples R China
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