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Purpose <p>Partial nephrectomy (PN) has been performed for renal masses ≥7cm with promised oncological outcome, whereas their functional and volumetric changes remain unclear. This study aims to evaluate renal functional and volumetric changes after PN for renal masses ≥7cm and compare these outcomes with those of with smaller renal masses(&lt;7cm).</p> Methods <p>A total of 107 patients with renal masses ≥7 cm who underwent PN with sufficient data were included. PN patients with renal masses &lt;7 cm were enrolled as controls. The acute ipsilateral renal dysfunction (AIRD) spectrum score, recovery from ischemia and annual ipsilateral renal parenchymal volume (RPV) decrease was used to reflect short, mid, and long-term functional/volumetric changes, respectively. </p> Result <p>The median tumor size in the study group was 8cm (interquartile range [IQR]: 7.5-9cm) with a median R.E.A.N.L. score of 10(IQR: 8-10) and the median ischemia time was 30 minutes, which were all significantly higher than those in the control group. Although the study group demonstrated lower ipsilateral renal parenchymal volume preservation (81.5% vs. 88.3%) and GFR preservation(74.6% vs. 84.4%, both p &lt; 0.001), spectrum sore(0.25 vs. 0.21, p=0.2), recovery from ischemia(91.6% vs. 93.8%, p=0.2) and annual ipsilateral RPV decrease(5.5% vs. 3.4%, p=0.3) were comparable between the two groups. The main limitations include a relatively small sample size and limited follow-up duration.</p> Conclusions <p>Compared with smaller renal masses(&lt;7 cm), PN for masses ≥7 cm was associated with moderately reduced ipsilateral RPV and GFR preservation. However, the severity of acute kidney injury (AKI), mid-term functional recovery, and long-term volumetric changes were not significantly compromised , supporting the feasibility of PN for large renal masses.</p>

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Functional and volumetric changes following partial nephrectomy for large (≥ 7 cm) renal masses: a comparative study

  • 期刊论文

  • 发表日期：

    2026年2月24日

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  • Cheng Luo,
  • Guanghan Zhang,
  • Yixin Huang,
  • Xiaohua Liu,
  • Shaohan Yin,
  • Huiming Liu,
  • Xiangpeng Zou,
  • Xin Luo,
  • Longbin Xiong,
  • Zhaohui Zhou,
  • Yulu Peng,
  • Xiaofeng Yang,
  • Lihao Zhang,
  • Binglei Ma,
  • Wensu Wei,
  • Fangjian Zhou,
  • Hui Han,
  • Shengjie Guo,
  • Pei Dong,
  • Guohua Zeng,
  • Chunping Yu,
  • Zhiling Zhang

摘要

Purpose

Partial nephrectomy (PN) has been performed for renal masses ≥7cm with promised oncological outcome, whereas their functional and volumetric changes remain unclear. This study aims to evaluate renal functional and volumetric changes after PN for renal masses ≥7cm and compare these outcomes with those of with smaller renal masses(<7cm).

Methods

A total of 107 patients with renal masses ≥7 cm who underwent PN with sufficient data were included. PN patients with renal masses <7 cm were enrolled as controls. The acute ipsilateral renal dysfunction (AIRD) spectrum score, recovery from ischemia and annual ipsilateral renal parenchymal volume (RPV) decrease was used to reflect short, mid, and long-term functional/volumetric changes, respectively.

Result

The median tumor size in the study group was 8cm (interquartile range [IQR]: 7.5-9cm) with a median R.E.A.N.L. score of 10(IQR: 8-10) and the median ischemia time was 30 minutes, which were all significantly higher than those in the control group. Although the study group demonstrated lower ipsilateral renal parenchymal volume preservation (81.5% vs. 88.3%) and GFR preservation(74.6% vs. 84.4%, both p < 0.001), spectrum sore(0.25 vs. 0.21, p=0.2), recovery from ischemia(91.6% vs. 93.8%, p=0.2) and annual ipsilateral RPV decrease(5.5% vs. 3.4%, p=0.3) were comparable between the two groups. The main limitations include a relatively small sample size and limited follow-up duration.

Conclusions

Compared with smaller renal masses(<7 cm), PN for masses ≥7 cm was associated with moderately reduced ipsilateral RPV and GFR preservation. However, the severity of acute kidney injury (AKI), mid-term functional recovery, and long-term volumetric changes were not significantly compromised , supporting the feasibility of PN for large renal masses.