Partial nephrectomy versus radical nephrectomy for T1bN0M0 clear cell renal cell carcinomas: A population-based propensity score-matched analysis

Purpose: Clear cell renal cell carcinoma (cc-RCC) comprises 70% of RCC and the majority of cancer-related deaths. The oncological comparison between partial nephrectomy (PN) and radical nephrectomy (RN) is undefined and previous studies have not indicated any significant benefit from PN compared with RN, for T1b renal tumors in terms of overall survival (OS). We retrieved T1bN0M0 cc-RCC patients and performed propensity score matching (PSM) to compare the oncological OS between PN and RN.Method: All cc-RCC cases were divided into two groups according to different surgical approaches, namely, PN and RN. Log-rank tests were used to assess the differences in OS, and subgroup analysis was performed in terms of age and tumor size. PSM was performed between the PN and RN groups.Results:11,966 T1bN0M0 cc-RCC patients were collected. After PSM, the log-rank test indicated that PN patients had better prognoses than those with RN. Age subgroup analysis indicated that PN was better than RN in all age subgroups. Cox analysis revealed that younger, larger tumor size, Black, and RN were associated with worse survival.Conclusion: PN had significantly better oncological prognoses than RN for T1bN0M0 cc-RCC patients, and age, race, tumor size, and surgical approach were effective prognostic factors.