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Cited 3 time in webofscience Cited 3 time in scopus
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Impact of short warm ischemic time on longitudinal kidney function and survival rate after partial nephrectomy for renal cell carcinoma in patients with pre-existing chronic kidney disease stage III: A multi-institutional propensity score-matched study

Authors
Chung, J.-S.Hong, S.K.Lee, S.C.Jeong, C.W.Kwak, C.Kim, H.H.Hong, S.H.Kim, Y.J.Kang, S.H.Chung, J.Kwon, T.G.Chang, Hwang E.Byun, S.-S.
Issue Date
Feb-2021
Publisher
W.B. Saunders Ltd
Keywords
Carcinoma; Chronic kidney disease; Nephrectomy; Renal cell; Warm ischemia
Citation
European Journal of Surgical Oncology, v.47, no.2, pp 470 - 476
Pages
7
Indexed
SCIE
SCOPUS
Journal Title
European Journal of Surgical Oncology
Volume
47
Number
2
Start Page
470
End Page
476
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/28342
DOI
10.1016/j.ejso.2020.06.016
ISSN
0748-7983
1532-2157
Abstract
Purpose: It remains unclear whether a short warm ischemic time (WIT) improves long-term renal function after partial nephrectomy (PN) for patients with pre-existing chronic kidney disease (CKD). We evaluated renal function after PN according to WIT duration in patients with stage III CKD. Materials and methods: We identified 277 patients with stage III CKD who underwent PN during 2004–2017. Propensity score matching was used to created two matched groups of patients: Group A (WIT of <25 min) and Group B (WIT of ≥25 min). The outcomes of interest were longitudinal kidney function change, new-onset stage IV CKD (eGFR <30 mL/min/1.73 m2) and overall survival. Results: The two matched groups contained 85 patients each. The median follow-up durations were 49 months in Group A and 42 months in Group B. The median pre-treatment eGFRs were 52.4 mL/min/1.73 m2 in Group A and 52.6 mL/min/1.73 m2 in Group B. There were no differences in kidney function between the two groups throughout the follow-up period (P > 0.05). The 5-year rates of new-onset stage IV CKD were not significantly different between Group A and Group B (8.2% vs. 7.1%), with no significant difference in the risk of developing stage IV CKD in Group A (vs. group B, hazard ratio: 0.527, 95% confidence interval: 0.183–1.521; P = 0.236). The 5-year overall survival rates were 90.3% for Group A and 96.2% for Group B (P = 0.549). Conclusions: A short WIT was not associated with better postoperative kidney function or survival after PN in patients with stage III CKD. © 2020 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology
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