ArticleWorld journal of urology2026
Partial nephrectomy for clinical T2b, T3a, and T3b renal mass: evaluating trifecta achievement and surgical outcomes.
Article in World journal of urology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo evaluate the feasibility, and outcomes of partial nephrectomy (PN) for clinical T2b, T3a, and T3b renal mass in a high-volume tertiary care setting.
methodsWe retrospectively analyzed patients who underwent open or robotic-assisted PN between 2017 and 2024 at a single academic center. Patients had imperative indications for PN [solitary kidney, chronic kidney disease CKD, bilateral neoplasm]. Data on perioperative outcomes, renal function, oncologic endpoints, and Trifecta achievement [no major surgical complications according to Clavien-Dindo classification (CD ≥ 3), negative surgical margins, 80% of estimated new baseline estimated glomerular filtration rate (eGFR)] were collected. Multivariable Firth logistic regression (MLRA) assessed predictors of failure to achieve Trifecta.
resultsWe analyzed 103 patients with (12 T2b/88 T3a/3 T3b) renal mass (median tumor size 6.0 cm/median R.E.N.A.L. score 10). Median ischemia time was 37.0 min (cold in 45.6%, warm in 44.7% and segmental/clampless in 9.7%). Median blood loss was 200 mL. Major post-operative complications occurred in 20.4% [urine leak (9.7%), fluid collection (6.7%), hematoma (2.9%)]. Intraoperative complication rate was 1.9% (2 enterotomies). Microscopic positive surgical margins were observed in 10.7%; mean ΔeGFR was - 14.6 ml/min/1.73m
conclusionPN for large and complex locally-advanced renal tumors is feasible with acceptable outcomes in carefully selected patients with imperative indication for nephron preservation. Further investigation is requisite to delineate role of PN in locally-advanced renal mass.
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