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08-02-2024 | Hematuria | Urologic Oncology

Gross Hematuria Does not Affect the Selection of Nephrectomy Types for Clinical Stage 1 Clear Cell Renal Cell Carcinoma: A Multicenter, Retrospective Cohort Study

Authors: Zhuo Xing, MD, Haozhe Xu, MD, Kai Ai, MD, Haitao Deng, MM, Yulong Hong, MM, Piye Deng, MM, Jie Wang, MD, Wei Xiong, MD, Zhi Li, MM, Lingfei Zhu, MD, Yuan Li, MD

Published in: Annals of Surgical Oncology | Issue 5/2024

Abstract

Purpose

This study aimed to discuss the correlation between gross hematuria and postoperative upstaging (from T1 to T3a) in patients with cT1 clear cell renal cell carcinoma (ccRCC) and to compare oncologic outcomes of partial nephrectomy (PN) and radical nephrectomy (RN) in patients with gross hematuria.

Methods

A total of 2145 patients who met the criteria were enrolled in the study (including 363 patients with gross hematuria). The least absolute selection and shrinkage operator logistic regression was used to evaluate the risk factor of postoperative pathological upstaging. The propensity score matching (PSM) and stable inverse probability of treatment weighting (IPTW) analysis were used to balance the confounding factors. The Kaplan–Meier analysis and multivariate Cox proportional risk regression model were used to assess the prognosis.

Results

Gross hematuria was a risk factor of postoperative pathological upstaging (odds ratio [OR] = 3.96; 95% confidence interval [CI] 2.44–6.42; P < 0.001). After PSM and stable IPTW adjustment, the characteristics were similar in corresponding patients in the PN and RN groups. In the PSM cohort, PN did not have a statistically significant impact on recurrence-free survival (hazard ratio [HR] = 1.48; 95% CI 0.25–8.88; P = 0.67), metastasis-free survival (HR = 1.24; 95% CI 0.33–4.66; P = 0.75), and overall survival (HR = 1.46; 95% CI 0.31–6.73; P = 0.63) compared with RN. The results were confirmed in sensitivity analyses.

Conclusions

Although gross hematuria was associated with postoperative pathological upstaging in patients with cT1 ccRCC, PN should still be the preferred treatment for such patients.

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Title: Gross Hematuria Does not Affect the Selection of Nephrectomy Types for Clinical Stage 1 Clear Cell Renal Cell Carcinoma: A Multicenter, Retrospective Cohort Study
Authors: Zhuo Xing, MD
Haozhe Xu, MD
Kai Ai, MD
Haitao Deng, MM
Yulong Hong, MM
Piye Deng, MM
Jie Wang, MD
Wei Xiong, MD
Zhi Li, MM
Lingfei Zhu, MD
Yuan Li, MD
Publication date: 08-02-2024
Publisher: Springer International Publishing
Keywords: Hematuria
Nephrectomy
Nephrectomy
Nephrectomy
Kidney Cancer
Kidney Cancer
Kidney Cancer
Published in: Annals of Surgical Oncology / Issue 5/2024
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-024-14958-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Gross Hematuria Does not Affect the Selection of Nephrectomy Types for Clinical Stage 1 Clear Cell Renal Cell Carcinoma: A Multicenter, Retrospective Cohort Study

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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