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    Factors affecting long-term renal functions after partial vs radical nephrectomy for clinical T1 renal masses: A Multicentre Study of the Urooncology Association, Turkey
    (Wiley-Hindawi, 2021) Izol, Volkan; Gokalp, Fatih; Sozen, Sinan; Ozden, Ender; Bayazit, Yildirim; Muezzinoglu, Talha; Kara, Onder
    Purpose To compare the functional outcomes of patients who underwent partial (PN) or radical nephrectomy (RN) for clinical T1 (cT1) renal tumours using the Kidney Cancer Database of the Urooncology Association, Turkey. Methods We retrospectively reviewed 1004 patients who underwent PN and RN for cT1 renal tumours at multiple academic tertiary centres between 2000 and 2018. Patients with preoperative end-stage chronic kidney disease and/or metastatic disease were excluded. Results There were 452 patients in the PN group and 552 patients in the RN group. The median follow-ups were 74.9 and 83.7 months in RN and PN cohort. The eGFR was significantly reduced in both groups on postoperative day 1 (PN = 13.7 vs RN = 19.1 mL/min/1.73 m(2): P < .001). In the PN group, eGFR showed a tendency to recover according to a quadratic pattern and reached preoperative levels in the first and third years (95.6 +/- 28.8 mL/min/1.73 m(2) and 96.9 +/- 28.9 mL/min/1.73 m(2), respectively), with no significant difference between the eGFRs in the 1st and 3rd years (P = .710). To define groups at risk, different cut-off values for the GFR were considered. Among patients with a baseline GFR < 90, the RN cohort had significantly lower eGFRs in the first and third years than the PN cohort (P = .02). Logistic regression showed that comorbidities, coronary artery disease, diabetes and hypertension had no adverse impacts on the changes in the eGFR (P = .60, P = .13, and P = .13, respectively). Conclusion For the treatment of stage T1 kidney tumours, open or laparoscopic partial nephrectomy has the benefit to preserve renal function.
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    Oncological outcomes of papillary versus clear cell renal cell carcinoma in pT1 and pT2 stage : Results from a contemporary Turkish patient cohort
    (Pagepress Publ, 2023) Cetin, Taha; Celik, Serdar; Sozen, Sinan; Akdogan, Bulent; Izol, Volkan; Aslan, Guven; Suer, Evren
    Objectives: To compare overall survival (OS), recurrence free survival (RFS), and cancer-specific survival (CSS) in the long-term follow-up of T1 and T2 clear-cell-Renal Cell Carcinoma (ccRCC) and papillary Renal Cell Carcinoma (pRCC) patients, as well as to determine the risk factors for recurrence and overall mortality. Material and method: Data of patients with kidney tumors obtained from the Urologic Cancer Database -Kidney (UroCaD-K) of Turkish Urooncology Association (TUOA) were evaluated retrospectively. Out of them, patients who had patho-logical T1-T2 ccRCC and pRCC were included in the study. According to the two histological subtype, recurrence and mor-tality status, RFS, OS and CSS data were analyzed. Results: RFS, OS and CSS of pRCC and ccRCC were found to be similar. Radiological local invasion was shown to be a risk fac-tor for recurrence in pRCC, and age was the only independent factor affecting overall mortality. Conclusions: There were no differences in survivals (RFS, OS and CSS) of patients with localized papillary and clear cell RCC. While age was the only factor affecting overall mortality, radiological local invasion was a risk factor for recurrence in papillary RCC.
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    What is the Optimal Time Period for Postponing Nephrectomy in Patients with Renal Cell Carcinoma of Various Stages?
    (Galenos Publ House, 2023) Celik, Serdar; Tinay, Iker; Sozen, Sinan; Ozen, Haluk; Akdogan, Bulent; Aslan, Gueven; Baltaci, Suemer
    Objective: The coronavirus disease-2019 pandemic has shown us that postponing elective surgeries that include nephrectomy due to renal cell carcinomas (RCC) was undertaken by the physicians to use hospital facilities in a balanced way. However, both urologists and patients were concerned about postponements that may increase the risk of progression. To determine the optimal threshold of postponement time-period for surgery (PTP) and according to the clinical T stages in patients who underwent nephrectomy due to RCC, we used the Urologic Cancer Database-Kidney.Materials and Methods: Patients who underwent detailed clinical T stage analysis with admission and surgery dates were included in the study. PTP was calculated using the dates of definitive preoperative diagnosis and surgery date. Recurrence, overall mortality (OM), recurrence-free survival, and overall survival (OS) were evaluated. The effects of PTP on oncological outcome according to tumor diameter and clinical T stages were also evaluated. We also analyzed the optimal cut-offs of PTP based on clinical T stages.Results: Among 3.258 patients, in the evaluation of 2.946 clinically localized patients, PTP and tumor diameter were found to be important predictors of recurrence (p=0.037 and p<0.001). The optimal PTP of 30 days was found to be an important significant threshold time for the T1 stage and 20 days for T2-4 stage tumors. Patients with longer PTP according to the thresholds shown in this study had higher upstaging for clinical T1a, T2a, and T3 stages; higher recurrence rates for T1b and T2b stages; and higher OM for T2a and T3 tumors. The survival have also shown that more than 20 days of PTP affected OSs for clinical-stage T1 (p=0.019), T2 (p=0.021) and T3 (p=0.007) tumors.Conclusions: All patients with tumors, including clinical T1 tumors, had worsening oncological results as the PTP increased (>20-30 days).