MP64-06 RECURRENCE AND SURVIVAL AFTER PARTIAL VERSUS RADICAL NEPHRECTOMY FOR T1 RENAL MASS
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Résumé
You have accessJournal of UrologyKidney Cancer: Localized V1 Apr 2014MP64-06 RECURRENCE AND SURVIVAL AFTER PARTIAL VERSUS RADICAL NEPHRECTOMY FOR T1 RENAL MASS Connor M. Forbes, Ricardo A. Rendon, Antonio Finelli, Anil Kapoor, Ronald B. Moore, Rodney H. Breau, Louis Lacombe, Jun Kawakami, Darrel E. Drachenberg, Stephen E. Pautler, Michael Jewett, Zhihui Liu, Simon Tanguay, and Peter C. Black Connor M. ForbesConnor M. Forbes More articles by this author , Ricardo A. RendonRicardo A. Rendon More articles by this author , Antonio FinelliAntonio Finelli More articles by this author , Anil KapoorAnil Kapoor More articles by this author , Ronald B. MooreRonald B. Moore More articles by this author , Rodney H. BreauRodney H. Breau More articles by this author , Louis LacombeLouis Lacombe More articles by this author , Jun KawakamiJun Kawakami More articles by this author , Darrel E. DrachenbergDarrel E. Drachenberg More articles by this author , Stephen E. PautlerStephen E. Pautler More articles by this author , Michael JewettMichael Jewett More articles by this author , Zhihui LiuZhihui Liu More articles by this author , Simon TanguaySimon Tanguay More articles by this author , and Peter C. BlackPeter C. Black More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.02.1923AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Partial nephrectomy for early stage renal cancer preserves renal function better than radical nephrectomy and is generally considered oncologically sound. The Intergroup EORTC prospective randomized phase 3 trial comparing oncologic outcomes after partial versus radical nephrectomy, however, has cast some doubt on this premise. This study aims to elucidate outcomes in partial versus radical nephrectomy for early stage tumours in the Canadian population. METHODS From 1989-2013, 1065 patients with a first occurrence of a clinical T1 renal mass who underwent partial or radical nephrectomy were identified from the Canadian Kidney Cancer Information System (CKCis), a national database of 2927 renal cancer patients. Baseline clinical, surgical, and pathologic parameters were collected. Progression-free survival was compared between types of surgery using a Cox proportional hazards model, adjusted for age at diagnosis, gender, clinical T stage, and diagnosis year. RESULTS Inclusion criteria were met by 726 partial and 339 radical nephrectomy patients, with median follow-up of 2.7 and 3.8 years, respectively. Pre-operative characteristics, surgical parameters and pathologic findings were similar in both groups, although patients undergoing radical nephrectomy more commonly had T1b disease (46% vs 19%) (Table 1). Unadjusted Kaplan-Meier progression-free survival was lower in radical than partial nephrectomy (log rank test, p=0.04). However, in the multivariable analysis, time to progression did not differ between radical and partial nephrectomy (hazard ratio 1.63, p=0.12, 95% C.I. 0.88 – 3.0). CONCLUSIONS These results indicate that progression-free survival does not differ between radical and partial nephrectomy in patients with T1 renal masses. This suggests that the selection of surgical approach should be based on other factors, including technical feasibility, potential complications and preservation of renal function. Table 1. Patient, tumour, and surgery characteristics Parameter Sub-Parameter Partial Nephrectomy Radical Nephrectomy Number - 726 (68%) 339 (32%) Age - 59 60 Gender Male 458 (63%) 208 (61%) - Female 268 (37%) 131 (39%) Clinical T stage T1 57 (8%) 25 (7%) - T1a 521 (72%) 130 (38%) - T1b 123 (19%) 118 (46%) Pathological N-stage N0 119 (17%) 93 (27%) - N1 2 (0%) 6 (2%) - Nx 601 (83%) 239 (71%) Histology chromophobe 62 (9%) 30 (9%) - clear cell 472 (68%) 240 (74%) - papillary 133 (19%) 51 (16%) - renal cell carcinoma 1 (0%) 1 (0%) - other 26 (4%) 4 (1%) Grade 1 98 (15%) 31 (10%) - 2 358 (56%) 168 (55%) - 3 169 (26%) 84 (28%) - 4 17 (3%) 21 (7%) Margin Status negative 649 (93%) 318 (98%) - positive 48 (7%) 5 (2%) Surgery open 402 (56%) 76 (23%) - laparoscopic 277 (38%) 255 (77%) - robotic 40 (6%) 1 (0%) Duration of surgery (min) - 153 163 Blood loss (mL) - 303 193 © 2014FiguresReferencesRelatedDetails Volume 191Issue 4SApril 2014Page: e702-e703 Advertisement Copyright & Permissions© 2014MetricsAuthor Information Connor M. Forbes More articles by this author Ricardo A. Rendon More articles by this author Antonio Finelli More articles by this author Anil Kapoor More articles by this author Ronald B. Moore More articles by this author Rodney H. Breau More articles by this author Louis Lacombe More articles by this author Jun Kawakami More articles by this author Darrel E. Drachenberg More articles by this author Stephen E. Pautler More articles by this author Michael Jewett More articles by this author Zhihui Liu More articles by this author Simon Tanguay More articles by this author Peter C. Black More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,009 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».