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Open Access Highly Accessed Research article

Comparison of baseline quality of life measures between renal cell carcinoma patients undergoing partial versus radical nephrectomy

Michelle L Arnold1, David D Thiel2, Nancy Diehl1, Kevin J Wu3, Steve Ames4 and Alexander S Parker1*

Author Affiliations

1 Department of Health Sciences Research, 4500 San Pablo Road, Jacksonville, FL 32224, USA

2 Department of Urology, 4500 San Pablo Road, Jacksonville, FL 32224, USA

3 Department of Anatomic Pathology, 4500 San Pablo Road, Jacksonville, FL 32224, USA

4 Department of Medicine at Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA

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BMC Urology 2013, 13:52  doi:10.1186/1471-2490-13-52

Published: 22 October 2013

Abstract

Background

To compare demographics, pathologic features, performance scores, comorbidities, symptoms and responses to quality of life (QoL) surveys between nephron-sparing surgery (NSS) and radical nephrectomy (RN) patients prior to surgical intervention. Previous investigators have compared QoL outcomes for patients undergoing RN and NSS; however, there are limited data comparing QoL-related characteristics at baseline between these groups.

Methods

We identified 144 patients with localized RCC who underwent either NSS (n = 71) or RN (n = 73) between May ‘07-November ‘12. We abstracted baseline data on demographic and clinic-pathologic variables as well as responses to the SF-36 and FACT-G surveys from our prospective registry. We amended the FACT-G with 8 additional questions designed to address RCC-specific QoL. For comparisons between the two groups, we employed Wilcoxon rank-sum and Fisher's Exact tests where appropriate.

Results

We observed RN patients to have more aggressive pathology. We noted no difference in performance scores between the two groups; however, RN patients were more likely to have higher Charlson scores (p = 0.022) and various symptoms at presentation (all p <0.001). For the QoL surveys, we did not observe differences on the FACT-G; however, we noted evidence of differential scores between the two groups on specific domains of the SF-36 (e.g. Mental Health; p 0.022) and the RCC-specific QoL questions added to the FACT-G.

Conclusions

We report baseline differences between RN and NSS patients on clinico-pathologic as well as QoL-related metrics. As issues of survivorship become increasingly important, our results underscore the need to consider baseline status in evaluations of QoL-related outcomes for patients undergoing surgery for RCC.

Keywords:
Kidney cancer; Quality of life; Radical nephrectomy; Nephron-sparing surgery