caa a22 4500 445335785 CHVBK 20180317142754.0 cr unu---uuuuu 170323e20110401xx s 000 0 eng 10.1245/s10434-010-1457-6 doi (NATIONALLICENCE)springer-10.1245/s10434-010-1457-6 Impact of Elective Versus Imperative Indications on Oncologic Outcomes After Open Nephron-Sparing Surgery for the Treatment of Sporadic Renal Cell Carcinomas [Elektronische Daten] [Grégoire Coffin, Vincent Hupertan, Lionel Taksin, Christophe Vaessen, Emmanuel Chartier-Kastler, Marc-Olivier Bitker, Morgan Rouprêt] Purpose: To determine the effect of nephron-sparing surgery (NSS) on cancer control in renal cell carcinomas (RCC) and to compare the outcomes of patients who had elective versus imperative indications for surgery. Methods: We performed a retrospective review of the data for patients treated with open NSS between 1980 and 2005 for sporadic RCCs. The following data were analyzed: age, intraoperative parameters, tumor size, Fuhrman grade, tumor, node, metastasis system disease stage, pathological data, and outcome. Results: A total of 155 patients with a median age of 60years were included. The mean preoperative and postoperative creatinine levels were 1.1±0.3mg/dl (range 0.6-2.6mg/dl) and 1.2±0.4mg/dl (range 0.5-3.4mg/dl), respectively. The mean tumor size was 3.8±2cm (range 1-10cm). Margin status was positive in 15 cases (9.70%), and multifocal RCCs were observed in 36 patients (23.2%). Overall, NSS indications were elective in 96 cases (61.9%) and imperative in 59 cases (38.1%). Univariate analysis found that elective cases were associated with better perioperative outcomes (P=0.01). In univariate analysis, tumor, node, metastasis system disease stage, multifocality, and indication were associated with recurrence (P<0.05). In the multivariate analysis, only multifocality status and imperatives indications were significant (P<0.05). The mean follow-up was 118.2±151months. The 5- and 10-year tumor-free survival rates were 81.8% and 78.7% in elective and imperatives cases, respectively. Conclusions: Oncologic control seems to be better for cases of elective open NSS. Thus, NSS should be advocated as soon as it is technically possible, regardless of the size of the tumor. Society of Surgical Oncology, 2010 Coffin Grégoire Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Hupertan Vincent Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Taksin Lionel Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Vaessen Christophe Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Chartier-Kastler Emmanuel Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Bitker Marc-Olivier Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Rouprêt Morgan Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1151-1157 1068-9265 18:4<1151 2011 18 10434 https://doi.org/10.1245/s10434-010-1457-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1245/s10434-010-1457-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Coffin Grégoire Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 700 1- Hupertan Vincent Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 700 1- Taksin Lionel Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 700 1- Vaessen Christophe Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 700 1- Chartier-Kastler Emmanuel Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 700 1- Bitker Marc-Olivier Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 700 1- Rouprêt Morgan Academic Department of Urology, La Pitié-Salpétrière Hospital, GHU EST, Assistance-Publique Hôpitaux de Paris, Hopital Pitié, Paris, France aut NATIONALLICENCE 773 0- Annals of Surgical Oncology Springer-Verlag 18/4(2011-04-01), 1151-1157 1068-9265 18:4<1151 2011 18 10434 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer