Clinical benefit and residual kidney function of en bloc nephrectomy for perirenal retroperitoneal sarcoma.

AIM: The purpose of this study was to evaluate the efficacy of en bloc nephrectomy for perirenal retroperitoneal sarcoma (RPS) with respect to postoperative kidney function and oncological benefits.

METHODS: We performed a comparative study of 114 patients undergoing surgery for primary RPS, classifying cases as nephrectomy (NPX, n = 65) versus no nephrectomy (no-NPX, n = 49). The Δ and % change between preoperative and postoperative estimated glomerulus filtration rate (eGFR) were analyzed to compare renal function changes after surgery. Kaplan-Meier analysis was performed to verify the incidence of local relapse between the two groups.

RESULTS: During a median follow-up of 29 months, median postoperative GFR of 65 patients in the NPX group decreased to 73.5% of preoperative eGFR. Although 38 patients (58%) in the NPX group experienced a progression in chronic kidney disease stage after nephrectomy, no patients progressed to end-stage renal disease (ESRD). In French Federation of Cancer Centers Sarcoma grade 2, the NPX group had statistically significant local control benefits, compared with the no-NPX group (P = 0.048).

CONCLUSIONS: Residual renal function after en bloc nephrectomy was stabilized without progression to ESRD. Moreover, en bloc nephrectomy for perirenal RPS might secure a complete resection margin for local tumor control.