Practice patterns for the surgical treatment of T1 renal cell carcinoma: a nationwide population-based register study.
Average rating
Cast your vote
You can rate an item by clicking the amount of stars they wish to award to this item.
When enough users have cast their vote on this item, the average rating will also be shown.
Star rating
Your vote was cast
Thank you for your feedback
Thank you for your feedback
Issue Date
2014-10
Metadata
Show full item recordCitation
Scand J Urol. 2014, 48 (5):445-52Abstract
Treatment of renal cell carcinoma (RCC) with radical nephrectomy (RN) induces chronic kidney disease more frequently compared with nephron-sparing surgery (NSS), which may have an impact on overall survival. Thus, NSS is recommended for RCCs up to 7 cm (T1). The aim of this study was to determine the extent to which these recommendations are implemented in clinical practice.Data were extracted from the Swedish National Kidney Cancer Register, a population-based register covering 98% of all RCCs in Sweden. In total, 3158 patients (1892 men, 1266 women) were primarily diagnosed with cT1N0M0 and treated surgically during 2005-2011. The administered treatments were evaluated between different hospitals as well as between the 21 independent healthcare counties.
In all, 742 patients were treated with NSS, 2339 with RN and 77 with minimally invasive ablative treatments. For cT1a RCC, patients treated with NSS increased from 22% in 2005 to 53% in 2011, and for cT1b from 2% to 10%. Nephron-sparing treatments for cT1a RCC were performed in 62% in university hospitals, 34% in intermediate- and 11% in low-volume hospitals. There was significant (p < 0.001) variation (31-67%) between the university hospitals and also for patient care in the 21 different counties (16-78%). There was an increased relative survival after NSS for T1a patients compared with RN. The register design by itself indicates limitations using data gathered from all Swedish hospitals.
NSS was underutilized in many hospitals and a patient's chance of being offered NSS varied according to their place of residence. Patients with cT1a RCC treated with NSS had a significantly better relative survival than those treated with RN.
Description
To access publisher's full text version of this article click on the hyperlink at the bottom of the pageAdditional Links
http://dx.doi.org/ 10.3109/21681805.2014.898686Rights
Archived with thanks to Scandinavian journal of urologyae974a485f413a2113503eed53cd6c53
10.3109/21681805.2014.898686
Scopus Count
Collections
Related articles
- Nephron-sparing surgery is equally effective to radical nephrectomy for T1BN0M0 renal cell carcinoma: a population-based assessment.
- Authors: Crépel M, Jeldres C, Perrotte P, Capitanio U, Isbarn H, Shariat SF, Liberman D, Sun M, Lughezzani G, Arjane P, Widmer H, Graefen M, Montorsi F, Patard JJ, Karakiewicz PI
- Issue date: 2010 Feb
- Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy.
- Authors: Leibovich BC, Blute M, Cheville JC, Lohse CM, Weaver AL, Zincke H
- Issue date: 2004 Mar
- Tumour characteristics and surgical treatment of renal cell carcinoma in Sweden 2005-2010: a population-based study from the national Swedish kidney cancer register.
- Authors: Thorstenson A, Bergman M, Scherman-Plogell AH, Hosseinnia S, Ljungberg B, Adolfsson J, Lundstam S
- Issue date: 2014 Jun
- A prospective, randomised EORTC intergroup phase 3 study comparing the oncologic outcome of elective nephron-sparing surgery and radical nephrectomy for low-stage renal cell carcinoma.
- Authors: Van Poppel H, Da Pozzo L, Albrecht W, Matveev V, Bono A, Borkowski A, Colombel M, Klotz L, Skinner E, Keane T, Marreaud S, Collette S, Sylvester R
- Issue date: 2011 Apr
- Age distribution for partial and radical nephrectomy: whose nephrons are being spared?
- Authors: von Klot C, Herrmann TR, Wegener G, Kuczyk MA, Hupe MC, Akkoyun M, Peters I, Kramer MW, Merseburger AS
- Issue date: 2013 Oct