Partial nephrectomy (PN) is superior to radical nephrectomy (RN) in preserving renal function even when tumors are larger than the traditional 4 cm cutoff, a new study suggests. Géraldine Pignot, MD, PhD, of Bicetre Hospital, Paris XI University, Le Kremlin Bicêtre, France, and colleagues analyzed data from 973 patients with renal tumors. The tumors were 4 cm or smaller in 665 cases (68.3%) and larger than 4 cm in 308 cases (31.7%). Surgeons performed PN in 663 cases (68.1%) and RN in 310 (31.9%). Patients who underwent PN had a smaller risk for experiencing significant changes in glomerular filtration rate (GFR) regardless of tumor size, according to findings published online ahead of print in Urologic Oncology. In multivariate analysis, the use of RN, a preoperative GFR below 60 mL/min/1.73 m2, a tumor size larger than 4 cm, and older age at diagnosis independently predicted significant postoperative GFR loss.
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Use of statins is associated with a reduced risk of progression of localized renal cell carcinoma, according to research published in The Journal of Urology. In an effort to assess the effect of statin medications on the progression of the neoplasm, Robert J. Hamilton, M.D., M.P.H., of the Memorial Sloan-Kettering Cancer Center in New York City, and colleagues analyzed data for 2,608 patients receiving surgical treatment for localized renal cell carcinoma. The researchers found that 27 percent of the patients undergoing surgery for localized renal cell carcinoma were statin users. At a median follow-up of 36 months, statin use was associated with a significant reduction in the risk of progression of localized renal cell carcinoma following surgery (hazard ratio [HR], 0.67; 95 percent confidence interval [CI], 0.47 to 0.96; P = 0.028) and a nonsignificant reduction in overall mortality (HR, 0.89; 95 percent CI, 0.71 to 1.13; P = 0.3). When statin use was modeled as a time-dependent covariate, the reduction in risk of progression of disease was decreased (HR, 0.77; P = 0.12) and the reduction in risk of overall mortality was increased (HR, 0.71; P = 0.002). "This is the first study to directly examine the association between statin use at surgery and progression to metastasis or renal cell carcinoma death," the authors write. |
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