Efficiency and safety of organ-sparing surgery for locally advanced kidney cancer

Objective: to evaluate the efficiency of surgical treatment in patients with locally advanced kidney cancer (KC), by comparing the immediate and late results of organ-sparing surgery (OSS) and nephrectomies.
Subjects and methods. The results of surgical treatment were analyzed in 251 patients with KC who had undergone OSS (n = 124) or nephrectomy (n = 127). The groups were matched for gender, age, stage, and baseline glomerular filtration rate. Surgical complications were evaluated according to the Clavien-Dindo classification. Survival rates were calculated using the Kaplan-Meier method. 
Results. There were no significant differences between the two patient groups in the amount of blood loss (median 300 ml) and in the hospital length of stay. The median renal ischemia time was 15.0±3.4 min. Complications after OSS and nephrectomies occurred in 10.4 and 4.7% of cases. The OSS group was found to tend to have higher 5-year overall survival rates (89.1%) than the nephrectomy group (70.6%) (p = 0.248). Conclusion. OSS is an effective, safe treatment option for KC, at the same time it is still inadequately frequently used in wide clinical practice. The OSS group was found to tend to have higher 5-year overall and relapse-free survival rates than the nephrectomy group (p > 0.05). 

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