신장암에 대한 부분 신절제술 활용 경향 분석

Purpose: Partial nephrectomy has a similar oncologic outcome to radical nephrectomy while reducing cardiac and metabolic morbidity. However, previous studies reported that partial nephrectomy had been underutilized. The purpose of this study is to analyze trends in the use of partial nephrectomy in Korea and evaluate which individual factors and hospital factor influenced the operative approach. Materials and Methods: Using URO-PDS database, 11560 patients underwent nephrectomy for renal cell carcinoma between 2006 and 2010 were identified. International Classification of Disease (ICD-9) diagnosis codes were applied to target subject of interest. Logistic regression was applied to identify determinants of partial nephrectomy. Results: Over the study period, the proportion of partial nephrectomies has steadily increased from 9.4% in 2006 to 30.4% in 2010 (p＜0.001). Deviation of utilization in partial nephrectomy has been observed based on the area (p＜0.001) and type of surgery (p＜0.001). Individual of younger age, as well as male, were more likely to be treated with partial nephrectomy (p＜0.001 for each). Furthermore, Patient treated at hospitals with higher nephrectomy volume were more prone to be treated with partial nephrectomy (p＜0.001 for each). Conclusions: Partial nephrectomies have been increasingly performed over the study period but are still underutilized.