OBJECTIVE: The objective of the present study was to analyse whether nephron-sparing surgery (NSS) was superior to radical nephrectomy (RN) in preserving renal function outcome in @entity5 larger than 4cm. METHODS: The data from 888 @entity1 who had been operated upon at eight french university hospitals were retrospectively analyzed. Glomerular filtration rate (GFR) pre- and post-surgery was calculated with the abbreviated @entity8 ( @entity8 ) equation. For a fair comparison between the two techniques, all imperative indications for NSS and all GFR<30 mL/ @entity1009 .73 m(2) were excluded from analysis. A shift to a less favorable DFG group following surgery was considered clinically significant. RESULTS: Seven hundred and thirty @entity1 were suitable for comparison. Median age at diagnosis was 60 years (19-88). @entity5 measuring more than 4cm represented 359 (49.2%) cases. NSS and RN were performed in 384 (52.6%) and 346 (47.4%) @entity1 , respectively. In univariate analysis, @entity1 undergoing NSS had a smaller risk than RN of developing significant GFR change following surgery. This was true for @entity5 <=4cm (P=0.0001) and for @entity5 >4cm (P=0.018). In multivariate analysis, the following criteria were independent predictive factors for developing significant postoperative GFR loss: the use of RN (P=0.001), decreased preoperative DFG (P=0.006), increased age at diagnosis (P=0.001) and increased ASA score (P=0.004). CONCLUSION: The renal function benefit offered by elective NSS over RN persists even when expanding NSS indications beyond the traditional 4 cm cut-off.

[Nephron-sparing surgery is superior to radical nephrectomy in preserving renal function outcome in XXXX larger than 4 cm].

@entity5 :: ('MESH:D009369', 'Disease') :: ['Tumors', 'tumors'] @entity1 :: ('9606', 'Species') :: ['patients'] @entity8 :: ('MESH:D007674', 'Disease') :: ['MDRD', 'Modification of Diet in Renal Disease'] @entity1009 :: ('966', 'Gene') :: ['min/1']
@entity5 :: (MESH:D009369,Disease) :: ['tumors']
