Table 2. Summary of findings table.
| Outcome | No. of participants (studies) | Certainty of the evidence (GRADE)a | Relative effect (95% CI)b | Anticipated absolute effects | |
|---|---|---|---|---|---|
| Risk with PN | Risk difference with TE | ||||
| Residual renal function (GFR, mL/min/1.73 m2) Follow-up: perioperative MCID: 5i |
942 (4 NRSs) |
⨁◯◯◯ VERY LOWc,d |
- | The mean change of GFR ranged from -2.3 to -12.6 | MD 3.38 higher (1.52 higher to 5.23 higher) |
| Residual renal function (GFR, mL/min/1.73 m2) Follow-up: 1 to 3 months MCID: 5i |
256 (2 NRSs) |
⨁⨁◯◯ LOWc |
- | The mean change of GFR ranged from -6.2 to -8.0 | MD 1.04 higher (0.25 higher to 1.83 higher) |
| Residual renal function (GFR, mL/min/1.73 m2) Follow-up: beyond 3 months MCID: 5i |
542 (4 NRS) |
⨁◯◯◯ VERY LOWc,d |
- | The mean change of GFR ranged from -3.7 to -15 | MD 2.31 higher (1.4 lower to 6.01 higher) |
| Overall mortality (not reported) | - | - | - | - | - |
| Major adverse events Follow-up: median 13 to 37 months MCID: 3% absolute risk difference |
2,360 (10 NRSs) |
⨁◯◯◯ VERY LOWc,d,e |
RR 0.48 (0.30 to 0.79) |
Study population | |
| 57 per 1,000 | 30 fewer per 1,000 (40 fewer to 12 fewer) |
||||
| Cancer-specific mortality Follow-up: median 18 to 37 months MCID: 3% absolute risk difference |
551 (2 NRSs) |
⨁◯◯◯ VERY LOWc,d |
RR 0.90 (0.11 to 7.28) |
Study population | |
| 6 per 1,000 | 1 fewer per 1,000 (5 fewer to 35 more) |
||||
| Local recurrence Follow-up: median 13 to 37 months MCID: 3% absolute risk difference |
180 (1 RCT) |
⨁◯◯◯ VERY LOWf,g,h |
Not estimable | Study population | |
| - | - | ||||
| 870 (5 NRSs) |
⨁◯◯◯ VERY LOWc,d |
RR 1.33 (0.35 to 4.98) |
Study population | ||
| 10 per 1,000 | 3 more per 1,000 (6 fewer to 39 more) |
||||
| Distant metastasis Follow-up: median 18 to 37 months MCID: 3% absolute risk difference |
635 (3 NRSs) |
⨁◯◯◯ VERY LOWc,d |
RR 0.75 (0.22 to 2.56) |
Study population | |
| 18 per 1,000 | 6 fewer per 1,000 (14 fewer to 28 more) |
||||
| Positive margin Follow-up: perioperative MCID: 5% absolute risk difference |
180 (1 RCT) |
⨁⨁◯◯ LOWd,f |
RR 0.67 (0.11 to 3.90) |
Study population | |
| 33 per 1,000 | 11 fewer per 1,000 (30 fewer to 97 more) |
||||
| 2,528 (14 NRSs) |
⨁⨁◯◯ LOWc |
RR 0.72 (0.44 to 1.17) |
Study population | ||
| 50 per 1,000 | 14 fewer per 1,000 (28 fewer to 8 more) |
||||
| Overall adverse events Follow-up: median 13 to 37 months MCID: 5% absolute risk difference |
2,634 (13 NRSs) |
⨁◯◯◯ VERY LOWc,d,e |
RR 0.69 (0.57 to 0.83) |
Study population | |
| 250 per 1,000 | 78 fewer per 1,000 (108 fewer to 43 fewer) |
||||
| Hospital stay (days) Follow-up: perioperative MCID: 1 |
982 (6 NRSs) |
⨁⨁◯◯ LOWc |
- | The mean hospital stay ranged from 5.0 to 8.7 | MD 0.71 days lower (0.91 lower to 0.51 lower) |
Patient or population: patients with T1 renal tumor. Setting: retrospective study design/China, Japan, Italy, and USA. Intervention: TE. Comparison: PN.
CI, confidence interval; PN, partial nephrectomy; TE, tumor enucleation; GFR, glomerular filtration rate; MCID, minimal clinically important difference; NRS, nonrandomized study; MD, mean difference; RR, risk ratio; RCT, randomized controlled trial.
a:GRADE Working Group grades of evidence: (1) High certainty: We are very confident that the true effect lies close to that of the estimate of the effect. (2) Moderate certainty: We are moderately confident in the effect estimate. The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. (3) Low certainty: Our confidence in the effect estimate is limited. The true effect may be substantially different from the estimate of the effect. (4) Very low certainty: We have very little confidence in the effect estimate. The true effect is likely to be substantially different from the estimate of effect.
b:The risk in the intervention group (and its 95% CI) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI).
c:Downgraded by two levels for study limitations (NRS).
d:Downgraded by one level for imprecision (cross assumed threshold).
e:Downgraded by one level for publication bias.
f:Downgraded by one level for study limitations (RCT).
g:Downgraded by two levels for imprecision: very rare event.
h:No event in either group.
i:Mayne TJ, Nordyke RJ, Schold JD, Weir MR, Mohan S. Defining a minimal clinically meaningful difference in 12-month estimated glomerular filtration rate for clinical trials in deceased donor kidney transplantation. Clin Transplant 2021;35:e14326.