Many patients regain renal function following nephrectomy for RCC

Results of a new study published in the Journal of Urology showed that a large percentage of patients were able to regain preoperative renal function following radical nephrectomy for renal cell carcinoma (RCC). The findings confirm those from a prior study, in which approximately 50% of patients regained their preoperative estimated glomerular filtration rate (eGFR) within 2 years of the procedure.

“Overall, this study confirms that a substantial proportion of patients experience eGFR recovery following radical nephrectomy, that this recovery differs according to preoperative eGFR, and that tumor size and patient sex are important factors associated with eGFR recovery,” wrote Emily C. Zabor, MS, of the department of epidemiology and biostatistics at the Memorial Sloan Kettering Cancer Center, New York, NY, and colleagues.

In the prior study, Ms. Zabor and her colleagues reported that 49% of patients who underwent radical nephrectomy for kidney cancer at Memorial Sloan Kettering Cancer Center recovered their preoperative eGFR within 2 years of surgery. Younger age, preoperative eGFR 2, and female sex were associated with a greater likelihood of eGFR recovery.

To confirm these findings, the investigators conducted a multicenter retrospective study at three facilities with a high volume of kidney surgery.

Almost 2,000 patients who underwent radical nephrectomy for nonmetastatic RCC were included. The median age of patients was 64 years, and the median preoperative eGFR was 71.9 mL/min/1.73 m².

Patients with a preoperative eGFR 2 were significantly older and more likely to have diabetes and hypertension compared with patients with preoperative eGFR >60 mL/min/1.73 m².

Median follow-up was 3.7 years. In that time period, 45% of patients regained their preoperative eGFR within 2 years. The likelihood of renal function recovery was increased among patients with a lower preoperative eGFR.

After multivariable analysis, female sex was linked with an increased chance of eGFR recovery in those with a preoperative eGFR >60 mL/min/1.73 m². In addition, larger tumor size was significantly associated with eGFR recovery regardless of preoperative eGFR levels.

“This finding suggests that low eGFR should not be seen as a contraindication for a radical nephrectomy when such a procedure is otherwise indicated since the 1-year cumulative incidence of recovery was 64% in patients with preoperative eGFR < 60 in this study,” the authors wrote.

To read more about this study, click here.