Long-Term Kidney Prognosis in Patients with Urologic Cancer after Nephrectomy

Background: Recent advances in medical technology have contributed to improved survival rates among cancer patients. Long-term outcomes are important for cancer survivors, and renal function plays a significant role in determining these outcome. We investigate the long-term renal functions in patients with urology cancers following surgery. Methods: We analyzed the medical records of 1,661 patients with kidney, ureter and bladder cancer who underwent surgery without receiving chemotherapy at Korea university Anam Hospital and Guro Hospital from November 1999 to February 2019. Results: Out of the total patients, 356 (21.4%) and 396 (23.8%) patients underwent partial nephrectomy(PN) and radical nephrectomy(RN), respectively. The average eGFR was 82.5±18.6 mL/min/1.73m2 in the non-nephrectomy(NN) group, in the PN group it was 88.7±19.4 mL/min/1.73m2, and in the RN group, it was 80.1±21.9 mL/min/1.73m2. There was an average annual decrease of 4.4±17.3 mL/min/1.73m2 in eGFR in patients who did not undergo nephrectomy adjusted by multiple factors. PN group exhibited a greater decline in eGFR compared to the NN (5.5±11.2 mL/min/1.73m2,P=0.010). Furthermore, there was a greater decrease in eGFR in the RN group compared to the PN group (8.3±31.9 mL/min/1.73m2,P=0.024). The risk of a 20% and 30% decline in eGFR showed no significant difference between NN and PN group (RR, 0.69, 95% CI, 0.45-1.07; RR, 0.72, 95% CI, 0.40-1.29). However, there was a significant increase in the risk of a 20% and 30% decline in eGFR observed in the RN group compared to NN group (RR, 1.58, 95% CI, 1.09-2.29, P=0.015 and RR, 2.00, 95% CI, 1.24-3.25,P=0.005). Conclusion: The annual decline in eGFR was significantly different among patients who underwent PN, RN, and those who did not undergo nephrectomy. Preserving renal tissue is crucial for determining renal prognosis when undergoing nephrectomy.