Nephron sparing surgery in tumours greater than 7 cm

Summary Introduction Partial nephrectomy (PN) is the gold standard treatment for renal cell carcinomas under 4 cm. No robust data exists to recommend PN for tumours > 7 cm (cT2). The objective of this work is to evaluate the results of PN for cT2 tumours. Patients and methods All patients who underwent PN or radical nephrectomy (RN) for cT2 tumours between 2000 and 2013 at our institution have been included. Patient demographics, postoperative data including renal function, morbidity, mortality and oncologic outcomes were reviewed retrospectively and compared using χ 2 test, Mann–Whitney test, Kaplan–Meier method and log rank test. Results We included 130 patients, 49 (38%) in the PN group and 81 (62%) in the RN group, with a median follow-up of 42 months [19–69]. Variation of postoperative renal function at day 5 and last recorded value was significantly different between the groups ( P  = 0.03 and P P  = 0.002). There were no significant differences between the two groups for overall, recurrence free and specific survival ( P  = 0.55, P  = 0.55, P  = 0.24, respectively). In univariate analysis, the type of surgery (PN versus RN) was not associated with a significant difference of oncologic outcome (margins, survival). Conclusion PN can be offered for cT2 tumours with oncological outcomes similar to RN. Despite an increased morbidity, it remains acceptable with the demonstrated advantage of preservation of renal function. Level of evidence 4.