PD41-08 CHRONIC KIDNEY DISEASE AND END-STAGE RENAL DISEASE AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR T1A RENAL CELL CARCINOMA: A POPULATION-BASED STUDY
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Résumé
You have accessJournal of UrologyKidney Cancer: Localized: Surgical Therapy IV (PD41)1 Apr 2019PD41-08 CHRONIC KIDNEY DISEASE AND END-STAGE RENAL DISEASE AFTER RADICAL OR PARTIAL NEPHRECTOMY FOR T1A RENAL CELL CARCINOMA: A POPULATION-BASED STUDY Madhur Nayan*, Olli Saarela, Keith Lawson, Lisa Martin, Maria Komisarenko, and Antonio Finelli Madhur Nayan*Madhur Nayan* More articles by this author , Olli SaarelaOlli Saarela More articles by this author , Keith LawsonKeith Lawson More articles by this author , Lisa MartinLisa Martin More articles by this author , Maria KomisarenkoMaria Komisarenko More articles by this author , and Antonio FinelliAntonio Finelli More articles by this author View All Author Informationhttps://doi.org/10.1097/01.JU.0000556552.01352.65AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVES: Surgery remains the mainstay of treatment for localized renal cell carcinoma (RCC). However, there remains uncertainty whether partial nephrectomy is associated with a reduced risk of developing chronic kidney disease or end-stage renal disease compared to radical nephrectomy. Therefore, the objective of this study was to compare renal outcomes in patients undergoing partial or radical nephrectomy for T1a RCC. METHODS: We used administrative databases, several of which have been validated, to perform a population-based study of patients in Ontario, Canada, undergoing a partial or radical nephrectomy for T1a RCC between 1994 and 2014. We excluded patients with more than one nephrectomy or a previous history of chronic kidney disease, diabetes, or hypertension. The outcomes of interest were diagnosis of chronic kidney disease and end-stage renal disease requiring renal replacement therapy, defined as receipt of chronic dialysis or renal transplant. We used Cox proportional hazard models to evaluate the association between partial vs. radical nephrectomy and these outcomes. RESULTS: We identified 1967 patients that met inclusion criteria, of which 893 (45.5%) underwent partial nephrectomy. Patients undergoing partial nephrectomy were more likely to be younger, have a lower Charlson score, have smaller tumour sizes, and undergo surgery in more recent years. With a median follow-up in those without death of 7.6 years (interquartile range 4.3 - 12.9), 238 and 15 patients developed chronic kidney disease and end-stage renal disease, respectively. Multivariable Cox proportional hazard models found that partial nephrectomy was independently associated with a significantly reduced risk of chronic kidney disease (hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.10 to 0.25). On univariate analysis, partial nephrectomy was not significantly associated with receipt of renal replacement therapy (HR 0.26, 95% CI 0.06 to 1.17). CONCLUSIONS: Our population-based study comparing partial vs. radical nephrectomy for T1a renal cell carcinoma found that partial nephrectomy was associated with significantly reduced risk of chronic kidney disease. However, the need for renal replacement therapy occurred infrequently and there was no significant association with type of surgery. Source of Funding: none Toronto, Canada© 2019 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 201Issue Supplement 4April 2019Page: e747-e748 Advertisement Copyright & Permissions© 2019 by American Urological Association Education and Research, Inc.MetricsAuthor Information Madhur Nayan* More articles by this author Olli Saarela More articles by this author Keith Lawson More articles by this author Lisa Martin More articles by this author Maria Komisarenko More articles by this author Antonio Finelli More articles by this author Expand All 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 | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 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 ».