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Objectives To determine short-term differences in renal function evolution between patients with renal cell carcinoma ( RCC) submitted to radical nephrectomy ( RN) and living kidney donors matched for age and gender., To assess the role of co-morbidity as a risk factor for developing an estimated glomerular filtration rate ( eGFR) of <60 mL/min/1.73 m2., Patients and Methods In this retrospective study patients undergoing Radical Nefrectomy ( RN) between January 2000 and February 2011 for suspicion of localised RCC were matched by age and gender to living kidney donors., Renal function was compared between the groups using the Modification in Diet and Renal Disease ( MDRD) equation at 1 year after RN., Charlson co-morbidity score, incidence of hypertension, diabetes and cardiovascular disease were compared and assessed as predictors for developing an eGFR of <60 mL/min/1.73 m2., Results In all, 196 patients were included, 98 in each group., The mean age was respectively 60.6 ( RCC group) and 59.1 years (donors)., The 1-year postoperative mean eGFR (available in 89 patients with RCC and 87 donors) was similar, at a mean ( sd) of 56.7 (16.4) mL/min/1.73 m2 in patients with RCC and 56.2 (9.8) mL/min/1.73 m2 in donors ( P = 0.83)., In patients with RCC the incidence and severity of co-morbidities was significantly higher., A preoperative eGFR of 60-89 mL/min/1.73 m2 was the only independent risk factor for developing a postoperative eGFR of <60 mL/min/1.73 m2 (odds ratio 4.4, confidence interval 2.1-9.5, P < 0.001, 95% confidence interval)., Conclusions In our cohorts with advanced age the 1-year follow-up eGFR was similar in both groups., Despite increased co-morbidity in the RCC group there was no increased decline in renal function., Only reduced preoperative eGFR could be identified as risk factor for developing a postoperative eGFR of <60 mL/min/1.73 m2. [ABSTRACT FROM AUTHOR]

Purpose: To assess the use of prognostic factors and models in renal-cell carcinoma (RCC) and to gain insight in the motivations precluding prognosis estimation and the use of prognosticators. Materials and Methods: A questionnaire was sent to 110 urologists involved in the Clinical Research Office of the Endourological Society (CROES) Global Renal Mass Study. Frequencies were gathered using descriptive statistics. Results: The majority of the 86 responders worked in a university hospital in Europe. Most of the urologists (97.7%) used the tumor-node-metastasis (TNM) classification, and 44% performed prognosis estimations in all patients. The main reason not to estimate prognosis was lack of accuracy (20.9%) and of additional benefit (11.6%). In addition, clinical, laboratory, or pathologic factors were used by 89.5% of the urologists and biomarkers by 16.3%. Preoperative models were used by 20.9%, postoperative models by 38.4%, and metastatic models by 38.4%. The Raj and Motzer models were the most used in preoperative and metastatic settings, while no predominance among the different postoperative models was seen. The most important reasons to skip the use of models were 'lack of additional value' and 'lack of familiarity' reported by 30.2% and 27.9% of the responders, respectively. Conclusions: The TNM is the mainstay for assessing prognosis in RCC. Our data indicate that penetration of prognostic systems is, at most, moderate, suggesting limited use outside original developmental settings. On the contrary, clinical, laboratory, and pathologic factors are used by almost all urologists for prognosis estimations. The most important reason not to use models is the lack of additional value. [ABSTRACT FROM AUTHOR]