Oncological results of repeat partial nephrectomy in patients with recurrence after nephron-sparing procedures

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Abstract

Aim. To carried out a comparative analysis of the risk of complications and oncological results of repeat partial nephrectomy and radical nephrectomy in patients with local recurrence after previous organ-sparing procedures.

Materials and methods. Retrospective and prospective data of 64 patients with local recurrence of kidney cancer after nephron-sparing procedures. who underwent surgical treatment in the department of oncourology of the National Medical Research Center of Oncology named after N.N. Blokhin in the period from 2000 to 2022. A total of 37 (57.8%) patients of the main group underwent repeat partial nephrectomy, while in 27 (42.2%) patients in the control group a radical nephrectomy was done. Median follow-up was 35 (3–131; Q1–Q3: 13–57) months. Both groups were comparable in terms of demographic and clinical characteristics (p>0.05). The median time to detect relapse after previous partial nephrectomy was 24 (2–172) months.

Results. Complications were noted in 8 (21.6%) patients after repeat partial nephrectomy, compared to 29.6% in the control group (n=8) (p=0.563). A comparative analysis revealed a significant advantage in overall survival in patients of the main group (p=0.042). There were no significant differences between groups in cancer-specific and disease-free survival (p=0.369 and p=0.537, respectively).

Conclusion. Repeat partial nephrectomy for local recurrence of kidney cancer leads to an increase in overall survival compared to radical nephrectomy, in the absence of significant differences in cancer-specific and relapse-free survival.

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About the authors

V. B. Matveev

FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation

Email: nurlan_kj@mail.ru
ORCID iD: 0000-0001-7748-9527

Ph.D., MD, professor, corresponding member of the Russian Academy of Sciences, Deputy director for scientific and innovation work of the FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation, Head of the Department of Oncourology

Russian Federation, Moscow

N. K. Zhumabaev

FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation; FGAOU VO Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation

Author for correspondence.
Email: nurlan_kj@mail.ru
ORCID iD: 0000-0003-0649-3734

Ph.D. student of the Department of oncology and radiation therapy of the Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation, urological department of the FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation

Russian Federation, Moscow; Moscow

M. I. Komarov

FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation

Email: nurlan_kj@mail.ru

Researcher of urological department of the FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation

Russian Federation, Moscow

A. V. Klimov

FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation; FGAOU VO Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation

Email: nurlan_kj@mail.ru
ORCID iD: 0000-0003-0727-2976

Senior researcher of THE urological department of the FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation

Russian Federation, Moscow; Moscow

I. S. Stilidi

FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation; FGAOU VO Pirogov Russian National Research Medical University of the Ministry of Health of the Russian Federation

Email: nurlan_kj@mail.ru
ORCID iD: 0000-0002-0493-1166

Director of the FSBI "National medical research center of Oncology named after N.N. Blokhin" of the Ministry of Health of the Russian Federation, Ph.D., MD, professor, Academician of the Russian Academy of Sciences

Russian Federation, Moscow; Moscow

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2. Figure. Survival of patients with kidney cancer recurrence after previous organ-preserving surgery who underwent resection and radical nephrectomy (Kaplan-Meier)

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