OUTCOME OF STAGE T1 RENAL CELL CARCINOMA TREATED WITH PARTIAL NEPHRECTOMY: INITIAL EXPERIENCES FROM A TEACHING HOSPITAL IN BANGLADESH
PDF

Keywords

Partial Nephrectomy
T1 Renal Cell Carcinoma
Bangladesh

How to Cite

Morshed, M. S., Al-Asad, H., Alam, M. S., Lutful Hasan, A. N. M., Belal, M. T., Hossain, A. S., & Zaman, S. B. (2018). OUTCOME OF STAGE T1 RENAL CELL CARCINOMA TREATED WITH PARTIAL NEPHRECTOMY: INITIAL EXPERIENCES FROM A TEACHING HOSPITAL IN BANGLADESH. Public Health of Indonesia, 4(3), 91–99. https://doi.org/10.36685/phi.v4i3.205

Abstract

Background: Renal cell carcinoma accounts for 85% of all solid tumors of the kidney. For many years, radical nephrectomy was the stan­dard treatment for RCC. Partial nephrectomy has gradual­ly replaced radical nephrectomy over the past decade, es­pecially for T1 stage renal cell carcinoma. However, the benefit of partial nephrectomy on oncolog­ic outcomes is not well known.

Objective: to investigate the clinical outcome of partial nephrectomy on T1 renal cell carcinoma.

Methods: This prospective observational study was conducted in a single unit of urology department of Dhaka Medical College Hospital, Bangladesh from the period September 2014 to September 2017. Fourteen patients underwent partial nephrectomy during this period with renal mass based on eligibility criteria. Two follow up was done at three months and six months.

Result: Mean age of the patients undergoing surgery was 52.0± 3.8 (46.0 to 57.0 years) years. For the majority of the patients, tumour size was in a range of 3-7 cm. Average operative time was 90 minutes and mean ischaemic time was 16.5 ± 4.6 minutes (14.5 to 21.0 minutes). Histopathological reports correlated with clinical diagnosis and showed adequate surgical clear margin in every case.  There was no recurrence of tumour noticed during the two follow up periods. The different investigation did not reveal the impaired renal functional test during the follow-up period.

Conclusion: The clinical outcome of partial nephrectomy was found better in this study. Partial nephrectomy has the potential to replace radical nephrectomy for managing T1 tumours. However, there are some controversies regarding the post-operative oncological outcome. More studies are recommended to investigate the effect of partial nephrectomy for T1 tumours.

https://doi.org/10.36685/phi.v4i3.205
PDF

References

Becker, F., Siemer, S., Hack, M., Humke, U., Ziegler, M., & Stöckle, M. (2006). Excellent long-term cancer control with elective nephron-sparing surgery for selected renal cell carcinomas measuring more than 4 cm. European urology, 49(6), 1058-1064.

Belldegrun, A., Tsui, K.-H., deKernion, J. B., & Smith, R. B. (1999). Efficacy of nephron-sparing surgery for renal cell carcinoma: analysis based on the new 1997 tumor-node-metastasis staging system. Journal of Clinical Oncology, 17(9), 2868-2868.

Butler, B. P., Novick, A. C., Miller, D. P., Campbell, S. A., & Licht, M. R. (1995). Management of small unilateral renal cell carcinomas: radical versus nephron-sparing surgery. Urology, 45(1), 34-40.

Campbell, S. C., Novick, A. C., Belldegrun, A., Blute, M. L., Chow, G. K., Derweesh, I. H., . . . Matin, S. F. (2009). Guideline for management of the clinical T1 renal mass. The Journal of urology, 182(4), 1271-1279.

Dash, A., Vickers, A. J., Schachter, L. R., Bach, A. M., Snyder, M. E., & Russo, P. (2006). Comparison of outcomes in elective partial vs radical nephrectomy for clear cell renal cell carcinoma of 4–7 cm. BJU international, 97(5), 939-945.

Fernando, A., Fowler, S., O'brien, T., Surgeons, B. A. o. U., Abbasi, Z., Adamson, A., . . . Afzal, N. (2016). Nephron"sparing surgery across a nation–outcomes from the British Association of Urological Surgeons 2012 national partial nephrectomy audit. BJU international, 117(6), 874-882.

Gill, I. S., Matin, S. F., Desai, M. M., Kaouk, J. H., Steinberg, A., Mascha, E., . . . Novick, A. C. (2003). Comparative analysis of laparoscopic versus open partial nephrectomy for renal tumors in 200 patients. The Journal of urology, 170(1), 64-68.

Gupta, D., Luitel, B., Chalise, P., Chapagain, S., Subedi, P., Thakur, D., . . . Shrestha, G. (2014). Nephron Sparing Surgery in a Tertiary Care Center in Nepal-An Initial Experience. Laterality, 2, 3.

Hollingsworth, J. M., Miller, D. C., Daignault, S., & Hollenbeck, B. K. (2006). Rising incidence of small renal masses: a need to reassess treatment effect. Journal of the National Cancer Institute, 98(18), 1331-1334.

Huang, W. C., Levey, A. S., Serio, A. M., Snyder, M., Vickers, A. J., Raj, G. V., . . . Russo, P. (2006). Chronic kidney disease after nephrectomy in patients with renal cortical tumours: a retrospective cohort study. The lancet oncology, 7(9), 735-740.

Joniau, S., Eeckt, K. V., Srirangam, S. J., & Van Poppel, H. (2009). Outcome of nephron"sparing surgery for T1b renal cell carcinoma. BJU international, 103(10), 1344-1348.

Lam, J. S., Shvarts, O., & Pantuck, A. J. (2004). Changing concepts in the surgical management of renal cell carcinoma. European urology, 45(6), 692-705.

Lau, W. K., Blute, M. L., Weaver, A. L., Torres, V. E., & Zincke, H. (2000). Matched comparison of radical nephrectomy vs nephron-sparing surgery in patients with unilateral renal cell carcinoma and a normal contralateral kidney. Paper presented at the Mayo Clinic Proceedings.

Lee, C. T., Katz, J., Shi, W., Thaler, H. T., Reuter, V. E., & Russo, P. (2000). Surgical management of renal tumors 4 cm. or less in a contemporary cohort. The Journal of urology, 163(3), 730-736.

Leibovich, B. C., Blute, M. L., Cheville, J. C., Lohse, C. M., Weaver, A. L., & Zincke, H. (2004). Nephron sparing surgery for appropriately selected renal cell carcinoma between 4 and 7 cm results in outcome similar to radical nephrectomy. The Journal of urology, 171(3), 1066-1070.

Lerner, S. E., Hawkins, C. A., Blute, M. L., Grabner, A., Wollan, P. C., Eickholt, J. T., & Zincke, H. (1996). Disease outcome in patients with low stage renal cell carcinoma treated with nephron sparing or radical surgery. The Journal of urology, 155(6), 1868-1873.

Link, R. E., Bhayani, S. B., Allaf, M. E., Varkarakis, I., Inagaki, T., Rogers, C., . . . Kavoussi, L. R. (2005). Exploring the learning curve, pathological outcomes and perioperative morbidity of laparoscopic partial nephrectomy performed for renal mass. The Journal of urology, 173(5), 1690-1694.

Ljungberg, B., Bensalah, K., Canfield, S., Dabestani, S., Hofmann, F., Hora, M., . . . Merseburger, A. S. (2015). EAU guidelines on renal cell carcinoma: 2014 update. European urology, 67(5), 913-924.

Margulis, V., Tamboli, P., Jacobsohn, K. M., Swanson, D. A., & Wood, C. G. (2007). Oncological efficacy and safety of nephron"sparing surgery for selected patients with locally advanced renal cell carcinoma. BJU international, 100(6), 1235-1239.

McKiernan, J., Simmons, R., Katz, J., & Russo, P. (2002). Natural history of chronic renal insufficiency after partial and radical nephrectomy. Urology, 59(6), 816-820.

Mitchell, R. E., Gilbert, S. M., Murphy, A. M., Olsson, C. A., Benson, M. C., & McKiernan, J. M. (2006). Partial nephrectomy and radical nephrectomy offer similar cancer outcomes in renal cortical tumors 4 cm or larger. Urology, 67(2), 260-264.

Pahernik, S., Roos, F., Röhrig, B., Wiesner, C., & Thüroff, J. W. (2008). Elective nephron sparing surgery for renal cell carcinoma larger than 4 cm. The Journal of urology, 179(1), 71-74.

Patard, J.-J., Pantuck, A. J., Crepel, M., Lam, J. S., Bellec, L., Albouy, B., . . . Lacroix, B. (2007). Morbidity and clinical outcome of nephron-sparing surgery in relation to tumour size and indication. European urology, 52(1), 148-154.

Robson, C. J. (1963). Radical nephrectomy for renal cell carcinoma. The Journal of urology, 89(1), 37-42.

Siegel, R., Naishadham, D., & Jemal, A. (2012). Cancer statistics for hispanics/latinos, 2012. CA: a cancer journal for clinicians, 62(5), 283-298.

Van Poppel, H., Da Pozzo, L., Albrecht, W., Matveev, V., Bono, A., Borkowski, A., . . . Keane, T. (2011). 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. European urology, 59(4), 543-552.

Zaman, S. B. (2017). Detection of chronic kidney disease by using different equations of glomerular filtration rate in patients with type 2 diabetes mellitus: a cross-sectional analysis. Cureus, 9(6).

Zaman, S. B., & Hossain, N. (2017). Universal Health Coverage: A burning need for developing countries. Journal of Medical Research and Innovation, 1(1), 18-20.

Zaman, S. B., Hossain, N., Ahammed, S., & Ahmed, Z. (2017). Contexts and opportunities of e-health technology in medical care. Journal of Medical Research and Innovation, 1(2), AV1-AV4.

Zaman, S. B., Hossain, N., Rahman, A. E., & Islam, S. M. (2017). Can glycated hemoglobin act as a reliable glycemic indicator in patients with diabetic chronic kidney disease? evidence from the Northeast of Thailand. Medical Journal of Indonesia, 26(2), 102-108.

Cite this article as: Morshed, M. S., Al-Asad, H., Alam, M. S., Hasan, A. N. M. L., Belal, M. T., Hossain, A. S., Zaman, S. B. (2018). Outcome of stage T1 renal cell carcinoma treated with partial nephrectomy: Initial experiences from a teaching hospital in Bangladesh. Public Health of Indonesia, 4(3):91-99.

Authors who publish with Public Health of Indonesia agree to the following terms:

  1. Authors retain copyright licensed under a Creative Commons Attribution-NonCommercial CC BY-NC 4.0, which allows others to remix, tweak, and build upon the authors' work non-commercially, and although the others' new works must also acknowledge the authors and be non-commercial, they don't have to license their derivative works on the same terms.
  2. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). Authors can archive pre-print and post-print or publisher's version/PDF.

Downloads

Download data is not yet available.