ABSTRACT

Objective:

In some selected Renal Cell Carcinoma (RCC) cases long-term oncologic outcomes of nephron sparing surgery and radical nephrectomy are similar. In renal tumor cases, one of the main factors affecting the prognosis is histological subtype. In this study, we aimed to determine the factors that predict cancer specific survival in pathologically non-clear cell RCC cases after nephron sparing surgery.

Materials and Methods:

Data of 50 patients undergoing nephron sparing surgery for non-clear cell renal cell carcinoma and pathological T1-3N0M0 stage (according to 2010 TNM classification) between January 1998 and February 2014 was investigated retrospectively. All patients were evaluated for pathological T stage, Fuhrmann grade, tumor size, local recurrence, positive surgical border, microvascular invasion and metastatic progression.

Results:

For all patients, overall survival and cancer specific survival rates were 90% and 92%, respectively. Five years of cancer specific survival rate for papillar and non-papillar RCC groups were 92% and 78%, respectively (p=0.158). When the patients were separated into two groups according to Fuhrmann grade, 5 years cancer specific survival rate for grade 1-2 and grade 3-4 groups were 100% and 54%, respectively (p=0.002). In univariate analysis for cancer specific survival predicting, Fuhrmann grade, microvascular invasion, positive surgical border and local recurrence were statistically significant. However, in multivariate analysis, only Fuhrmann grade was statistically significant (p=0.014, HR: 5.58, %95 CI: 1.425-21.845).

Conclusion:

In non-clear cell RCC cases whatever the subtype is successful results have been taken with nephron sparing surgery. To evaluate the results of nephron sparing surgery, there is a need for studies which are prospective and have larger patient population.