KMID : 1001020230210030200
|
|
Journal of Urologic Oncology 2023 Volume.21 No. 3 p.200 ~ p.207
|
|
Preoperative Renal Artery Embolization Before Radical Nephrectomy for Nonmetastatic Renal Cell Carcinoma: A Propensity Score Matched Analysis
|
|
Noh Jin
Song Sang-Hun Jung Gyoo-Hwan Lee Sang-Chul Hong Sung-Kyu Byun Seok-Soo Kim Jung-Kwon
|
|
Abstract
|
|
|
Purpose : This study investigated the effects of preoperative renal artery embolization (PRAE) before radical nephrectomy (RN) for advanced nonmetastatic renal cell carcinoma (RCC) on perioperative and oncologic outcomes.
Materials and Methods : We analyzed 820 patients who had undergone RN for advanced nonmetastatic RCC (cT3-4/N0-1) between June 2003 and May 2022. Propensity score matching (PSM) at a 1:2 ratio was performed using the nearest-neighbor method, matching 121 PRAE patients to 242 controls. The primary endpoints included recurrence rate, overall survival, cancer-specific survival, and recurrence-free survival.
Results : Before PSM, there were differences in sex (p=0.047), clinical stage (p=0.001), and the Fuhrman grade (p<0.001) between the 2 groups. After PSM, the baseline characteristics were well balanced. The mean age at operation was 58.2¡¾13.0 years, and the median follow-up was 42.0 months. The postoperative transfusion rate was higher in PRAE group (18.2% vs. 10.7%, p=0.049). No significant differences were found between the PRAE and control groups in operation time (166.6¡¾95.3 minutes vs. 155.5¡¾74.2 minutes, p=0.263), estimated blood loss (360.4¡¾732.0 mL vs. 293.4¡¾596.6 mL, p=0.384), or length of hospital stay (7.7¡¾4.9 days vs. 7.7¡¾3.7 days, p=0.961) between the 2 groups. Recurrence was significantly less common in the PRAE group than in the control group (20.7% vs. 34.3%, p=0.007). No significant differences were found in cancer-specific death (8.3% vs. 9.1%, p=0.793) or overall death (8.3% vs. 12.0%, p=0.281). In multivariate logistic regression analysis, clinical T stage ¡Ã3 (odds ratio [OR], 4.365; p<0.001), clinical N stage 1 (OR, 2.405; p=0.020) and no PRAE (OR, 2.293; p=0.004) were independent predictors of recurrence.
Conclusions : Our results showed that PRAE was related to a lower recurrence rate. Thus, PRAE seems to be useful before RN for nonmetastatic RCC patients.
|
|
KEYWORD
|
|
Renal cell carcinoma, Nephrectomy
|
|
FullTexts / Linksout information
|
|
|
|
Listed journal information
|
|
|
|