Srivastava A, et al. - This study encompassed an estimation of the proportion of patients up-staged to T3a disease after partial nephrectomy (PN), stratified by clinical stage. Furthermore, it focused on characterizing their survival. T3a up-staging after PN with increasing initial T stage was experienced by a majority of the patients. Up-staged pT3a patients reported worse compared cancer-specific (CSS) across all clinical tumor stages after PN. This research failed to illustrate that patients up-staged after PN presented with compromised oncologic outcomes compared to all-comers with pT3a disease receiving radical nephrectomy (RN).

Methods

• This research selected pT1-pT3aN0M0 kidney cancer patients undergoing PN or radical nephrectomy (RN) from the Surveillance Epidemiology and End Results registries, from 1998 to 2013.
• A comparison was pursued via the Cox proportional hazards models of the cancer-specific (CSS) and overall survival (OS) for PN patients with pT1a, pT1b, and pT2 disease to stratified, up-staged pT3a patients undergoing PN.
• The PN patients were contrasted with up-staged pT3a disease to RN patients with pT3a disease.

Results

• The estimated proportion up-staged to pT3a was 4.2%, 9.5%, and 19.5% for cT1a, cT1b, and cT2, respectively, from the 28,854 patients undergoing PN.
• OS appeared to be worse for tumors up-staged from cT1a to pT3a, but not for cT1b or cT2 tumors.
• Worse CSS, with worse survival for larger tumors were exhibited by up-staged pT3a tumors, across all stage strata.
• There was no variation in OS or CSS for up-staged pT3a PN patients compared to pT3a RN patients.