The Long-Term Functional and Oncologic Outcomes of Kidney-Sparing Surgery in Upper Tract Urothelial Carcinoma
2025

Kidney-Sparing Surgery for Upper Tract Urothelial Carcinoma

Sample size: 252 publication 10 minutes Evidence: moderate

Author Information

Author(s): Wang Yu-Chieh MD, Li Jian-Ri MD, PhD, Chen Chuan-Shu MD, PhD, Wang Shian-Shiang MD, PhD, Yang Cheng-Kuang MD, PhD, Chiu Kun-Yuan MD, Hsu Chiann-Yi MSc

Primary Institution: Taichung Veterans General Hospital, Taichung, Taiwan

Hypothesis

This study aimed to compare the functional and oncological outcomes of kidney-sparing surgery (KSS) versus radical nephroureterectomy (RNU) in patients with upper tract urothelial carcinoma (UTUC).

Conclusion

Kidney-sparing surgery (KSS) does not compromise survival outcomes compared to radical nephroureterectomy (RNU) and offers better preservation of renal function.

Supporting Evidence

  • Overall survival at 8 years was 77.06% for RNU and 70.59% for KSS.
  • KSS was associated with a higher recurrence rate compared to RNU.
  • Postoperative renal function showed no significant difference at 1 year between KSS and RNU.

Takeaway

This study looked at two types of surgery for kidney cancer and found that one type, which saves the kidney, works just as well for survival and helps keep the kidney healthy.

Methodology

The study retrospectively analyzed 252 patients with UTUC treated with either RNU or KSS, assessing various survival and functional outcomes using statistical models.

Potential Biases

Selection bias may occur as patients with solitary kidney disease or a preference to avoid hemodialysis tended to choose KSS.

Limitations

The study's retrospective nature and non-randomized design may introduce selection bias and limit the strength of the evidence.

Participant Demographics

The study included 252 patients, with 218 undergoing RNU and 34 undergoing KSS, with a mean age of 69.63 years.

Statistical Information

P-Value

0.691

Confidence Interval

95% CI 0.75–3.15

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1245/s10434-024-16523-y

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