Erschienen in:
23.01.2020 | Urologic Oncology
Centralization of Health Care to Facilitate Greater Use of Nephron-Sparing Surgery for Localized Renal Tumors: Identifying Appropriate Health Care Delivery
verfasst von:
Jeffrey C. Morrison, MD, Boris Gershman, MD, Badrinath Konety, MD, MBA, Nicholas Cost, MD, Simon P. Kim, MD, MPH
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 6/2020
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Excerpt
Clinical practice guidelines have endorsed the principles of nephron-sparing surgery (NSS) to achieve comparable oncologic outcomes compared with radical nephrectomy (RN), while minimizing the morbidity from chronic kidney disease.
1–3 Indeed, the American Urological Association (AUA) recently further reinforced ‘prioritizing’ partial nephrectomy (PN), in particular for clinical T1a (< 4 cm) renal tumors, and limiting the RN for a specific set of criteria (higher complexity renal tumors with absence of pre-existing chronic kidney disease and proteinuria).
2 In response to the greater emphasis in NSS to clinical practice guidelines attributable to the growing evidence regarding similar oncologic control, population-based studies have demonstrated greater use of PN over time.
4–6 …