Outcomes of minimally invasive partial nephrectomy among very elderly patients: report from the RESURGE collaborative international database
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Outcomes of minimally invasive partial nephrectomy among very elderly patients: report from the RESURGE collaborative international database. / Larcher, Alessandro; Wallis, Christopher J D; Pavan, Nicola; Porpiglia, Francesco; Takagi, Toshio; Tanabe, Kazunari; Rha, Koon H; Raheem, Ali Abdel; Yang, Bo; Zang, Chao; Perdonà, Sisto; Quarto, Giuseppe; Maurer, Tobias; Amiel, Thomas; Schips, Luigi; Castellucci, Roberto; Crivellaro, Simone; Dobbs, Ryan; Baiamonte, Gianfranco; Celia, Antonio; De Concilio, Bernardino; Furlan, Maria; Lima, Estevão; Linares, Estefania; Micali, Salvatore; Amparore, Daniele; De Naeyer, Geert; Trombetta, Carlo; Hampton, Lance J; Tracey, Andrew; Bindayi, Ahmet; Antonelli, Alessandro; Derweesh, Ithaar; Mir, Carme; Montorsi, Francesco; Mottrie, Alexandre; Autorino, Riccardo; Capitanio, Umberto.
in: CENT EUR J UROL, Jahrgang 73, Nr. 3, 2020, S. 273-279.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Outcomes of minimally invasive partial nephrectomy among very elderly patients: report from the RESURGE collaborative international database
AU - Larcher, Alessandro
AU - Wallis, Christopher J D
AU - Pavan, Nicola
AU - Porpiglia, Francesco
AU - Takagi, Toshio
AU - Tanabe, Kazunari
AU - Rha, Koon H
AU - Raheem, Ali Abdel
AU - Yang, Bo
AU - Zang, Chao
AU - Perdonà, Sisto
AU - Quarto, Giuseppe
AU - Maurer, Tobias
AU - Amiel, Thomas
AU - Schips, Luigi
AU - Castellucci, Roberto
AU - Crivellaro, Simone
AU - Dobbs, Ryan
AU - Baiamonte, Gianfranco
AU - Celia, Antonio
AU - De Concilio, Bernardino
AU - Furlan, Maria
AU - Lima, Estevão
AU - Linares, Estefania
AU - Micali, Salvatore
AU - Amparore, Daniele
AU - De Naeyer, Geert
AU - Trombetta, Carlo
AU - Hampton, Lance J
AU - Tracey, Andrew
AU - Bindayi, Ahmet
AU - Antonelli, Alessandro
AU - Derweesh, Ithaar
AU - Mir, Carme
AU - Montorsi, Francesco
AU - Mottrie, Alexandre
AU - Autorino, Riccardo
AU - Capitanio, Umberto
N1 - Copyright by Polish Urological Association.
PY - 2020
Y1 - 2020
N2 - The aim of the study was to perform a comprehensive investigation of clinical outcomes of robot-assisted partial nephrectomy (RAPN) or laparoscopic partial nephrectomy (LPN) in elderly patients presenting with a renal mass. The REnal SURGery in Elderly (RESURGE) collaborative database was queried to identify patients aged 75 or older diagnosed with cT1-2 renal mass and treated with RAPN or LPN. Study outcomes were: overall complications (OC); warm ischemia time (WIT) and 6-month estimated glomerular filtration rate (eGFR); positive surgical margins (PSM), disease recurrence (REC), cancer-specific mortality (CSM) and other-cause mortality (OCM). Descriptive statistics, Kaplan-Meier, smoothed Poisson plots and logistic and linear regression models (MVA) were used. Overall, 216 patients were included in this analysis. OC rate was 34%, most of them being of low Clavien grade. Median WIT was 17 minutes and median 6-month eGFR was 54 ml/min/1.73 m2. PSM rate was 5%. After a median follow-up of 20 months, the 5-year rates of REC, CSM and OCM were 4, 4 and 5%, respectively. At MVA predicting perioperative morbidity, RAPN relative to LPN (odds ratio [OR] 0.33; p <0.0001) was associated with lower OC rate. At MVA predicting functional outcomes, RAPN relative to LPN was associated with shorter WIT (estimate [EST] -4.09; p <0.0001), and with higher 6-month eGFR (EST 6.03; p = 0.01). In appropriately selected patients with small renal masses, minimally-invasive PN is associated with acceptable perioperative outcomes. The use of a robotic approach over a standard laparoscopic approach can be advantageous with respect to clinically relevant outcomes, and it should be preferred when available.
AB - The aim of the study was to perform a comprehensive investigation of clinical outcomes of robot-assisted partial nephrectomy (RAPN) or laparoscopic partial nephrectomy (LPN) in elderly patients presenting with a renal mass. The REnal SURGery in Elderly (RESURGE) collaborative database was queried to identify patients aged 75 or older diagnosed with cT1-2 renal mass and treated with RAPN or LPN. Study outcomes were: overall complications (OC); warm ischemia time (WIT) and 6-month estimated glomerular filtration rate (eGFR); positive surgical margins (PSM), disease recurrence (REC), cancer-specific mortality (CSM) and other-cause mortality (OCM). Descriptive statistics, Kaplan-Meier, smoothed Poisson plots and logistic and linear regression models (MVA) were used. Overall, 216 patients were included in this analysis. OC rate was 34%, most of them being of low Clavien grade. Median WIT was 17 minutes and median 6-month eGFR was 54 ml/min/1.73 m2. PSM rate was 5%. After a median follow-up of 20 months, the 5-year rates of REC, CSM and OCM were 4, 4 and 5%, respectively. At MVA predicting perioperative morbidity, RAPN relative to LPN (odds ratio [OR] 0.33; p <0.0001) was associated with lower OC rate. At MVA predicting functional outcomes, RAPN relative to LPN was associated with shorter WIT (estimate [EST] -4.09; p <0.0001), and with higher 6-month eGFR (EST 6.03; p = 0.01). In appropriately selected patients with small renal masses, minimally-invasive PN is associated with acceptable perioperative outcomes. The use of a robotic approach over a standard laparoscopic approach can be advantageous with respect to clinically relevant outcomes, and it should be preferred when available.
U2 - 10.5173/ceju.2020.0179
DO - 10.5173/ceju.2020.0179
M3 - SCORING: Journal article
C2 - 33133653
VL - 73
SP - 273
EP - 279
JO - CENT EUR J UROL
JF - CENT EUR J UROL
SN - 2080-4806
IS - 3
ER -
