Tumor enucleation for the treatment of T1 renal tumors: A systematic review and meta-analysis

Hyun Chul Chung, Tae Wook Kang, Joon Young Lee, Eu Chang Hwang, Hong Jun Park, Jun Eul Hwang, Ki Don Chang, Young Hwan Kim, Jae Hung Jung

Research output: Contribution to journalArticlepeer-review


Purpose: To evaluate the clinical efficacy and safety of tumor enucleation (TE) compared with partial nephrectomy (PN) for T1 renal cell carcinoma. Materials and Methods: According to protocol, we searched multiple data sources for published and unpublished randomized controlled trials and nonrandomized studies (NRSs) in any language. We performed systematic review and meta-analysis according to the Cochrane Handbook for Systematic Reviews of Interventions and rated the certainty of the evidence (CoE) using the GRADE framework. Results: We are uncertain about the effects of TE on perioperative (mean difference [MD] 3.38, 95% CI 1.52 to 5.23; I2=68%; 4 NRSs; 942 participants; very low CoE) and long-term (MD 2.31, 95% CI-1.40 to 6.01; I2=57%; 4 NRSs; 542 participants; very low CoE) residual renal function. TE may result in little to no difference in short-term residual renal function (MD 1.04, 95% CI 0.25 to 1.83; I2=0%; 2 NRSs; 256 participants; low CoE). We are uncertain about the effects of TE on cancer-specific mortality (risk ratio [RR] 0.90, 95% CI: 0.11 to 7.28; I2=0%; 2 NRSs; 551 participants; very low CoE) and major adverse events (RR 0.48, 95% CI: 0.30 to 0.79; I2=0%; 10 NRS; 2,360 participants; very low CoE). Conclusions: While TE appears to have similar effects on short term postoperative residual renal function, there were uncertainties on mortality and major adverse events. However, we need rigorous RCTs to elucidate the effects of TE as the evidence stems mostly from NRSs.

Original languageEnglish
Pages (from-to)126-139
Number of pages14
JournalInvestigative and clinical urology
Issue number2
Publication statusPublished - 2022 Mar

Bibliographical note

Funding Information:
Six of 17 studies specified funding sources: 3 studies reported that they had no relevant financial interests[40,41,53], and 3 studies were funded by institutions [44,49,55]. Ten studies reported their conflicts of interest: 1 study reported that the corresponding author was the paid chairman of the AUA Practice Guidelines Committee and a paid consultant for the Urology Times [55] and 9 studies reported no conflicts of interests[40-43,45,47-49,56].

Funding Information:
This research was supported by the Center of Evidence Based Medicine, Institute of Convergence Science, Yonsei University, Seoul, Republic of Korea.

Publisher Copyright:
© The Korean Urological Association.

All Science Journal Classification (ASJC) codes

  • Urology


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