THE ROLE OF NEPHRON-SPARING SURGERY IN THE MANAGEMENT OF SMALL RENAL MASSES COMPARING THE ONCOLOGICAL OUTCOMES, RENAL FUNCTION PRESERVATION, AND COMPLICATION RATES OF PARTIAL NEPHRECTOMY VERSUS RADICAL NEPHRECTOMY

Background: Regarding oncological results and renal function, it is still unknown which patients with renal cell carcinoma (RCC) benefit more from partial nephrectomy (PN) as opposed to radical nephrectomy (RN). Objective: To evaluate the role of nephron-sparing surgery in the management of small renal masses comparing the oncological outcomes, renal function preservation, and complication rates of partial nephrectomy versus radical nephrectomy. Methods: This retrospective study was carried out at the Department of Urology Sindh Institute of Urology and Transplantation (SIUT) Karachi Pakistan. This study (n = 120) examines individuals who had RN or PN procedures between 2018 and 2023 in hindsight. Patients were matched by age, sex, RENAL score, and preoperative kidney function (eGFR) and categorized according to RN or PN. The eGFR change between the baseline and the 5-year follow-up was evaluated. Results: 60 patients in each group for analysis following matching. The PN group showed a greater recurrence incidence than the RN group for patients categorized as low risk (p = 0.01). RN patients exhibited lower 1-year postoperative eGFR than PN patients (p < 0.001). When compared to PN, RN was more likely to cause new-onset chronic kidney disease (CKD) stage ≥3b (p < 0.001). Following PN, the complication rate was much greater (p = 0.003). Conclusion: According to our research, PN has better postsurgical renal function. However, RN is a dependable course of treatment if maintaining renal function is not of utmost importance.