Partial nephrectomy for T3aN0M0 renal cell carcinoma: shall we step forward?

OBJECTIVES To evaluate the prognosis of non-metastatic T3a renal cell carcinoma (RCC) with partial nephrectomy (PN). PATIENTS AND METHODS We retrospectively evaluated 125 patients with non-metastatic T3a RCC. Patients undergoing PN and radical nephrectomy (RN) were strictly matched by clinic-pathologic characteristics. Log-rank test and Cox regression model were used for univariate and multivariate analysis. RESULTS 18 pair patients were matched and the median follow-up was 35.5 (10-86) months. PN patients had a higher postoperative eGFR than RN patients (P=0.034). Cancer-specific survival (CSS) and recurrence-free survival (RFS) did not differ between two groups (P=0.305 and P=0.524). On multivariate analysis, CSS decreased with positive surgical margin and anemia (both P<0.01) and RFS decreased with Furhman grade, positive surgical margin, and anemia (all P<0.01). CONCLUSIONS For patients with non-metastatic pT3a RCC, PN may be a possible option for similar oncology outcomes and better renal function.