The Adoption of Nephron-Sparing Surgery in Europe - A Trend Analysis in Two Referral Centers from Austria and Germany
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The Adoption of Nephron-Sparing Surgery in Europe - A Trend Analysis in Two Referral Centers from Austria and Germany. / Meyer, Christian; Hansen, Jens; Becker, Andreas; Schmid, Marianne; Pradel, Lea; Strini, Karin; Chromecki, Thomas; Jesche-Chromecki, Johanna; Fisch, Margit; Zigeuner, Richard; Chun, Felix K H.
in: UROL INT, Jahrgang 96, Nr. 3, 2016, S. 330-6.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - The Adoption of Nephron-Sparing Surgery in Europe - A Trend Analysis in Two Referral Centers from Austria and Germany
AU - Meyer, Christian
AU - Hansen, Jens
AU - Becker, Andreas
AU - Schmid, Marianne
AU - Pradel, Lea
AU - Strini, Karin
AU - Chromecki, Thomas
AU - Jesche-Chromecki, Johanna
AU - Fisch, Margit
AU - Zigeuner, Richard
AU - Chun, Felix K H
N1 - © 2015 S. Karger AG, Basel.
PY - 2016
Y1 - 2016
N2 - OBJECTIVE: To compare the trends of partial nephrectomy (PN) and radical nephrectomy (RN) in 2 European tertiary referral centers with regards to guideline changes.MATERIALS AND METHODS: A total of 1,573 patients who underwent RN or PN for localized (≤T2) renal cell carcinoma (RCC) were included. Logistic regression analyses assessed the predictors of PN and laparoscopy over time.RESULTS: Out of the total, 1,013 patients (65.6%) were treated with RN and 560 patients (34.4%) with PN. Also, 1,233 patients (80%) had open surgery whereas 340 patients (22%) were treated with a laparoscopic approach. Laparoscopic RN and PN were performed in 216 (13.7%) and 124 (7.8%) patients, respectively. T1b tumors were 73% less likely (p < 0.001) to be treated with PN compared to T1a tumors. The odds of undergoing PN or laparoscopy in 2008-2010 relative to 2000-2001 were 6.5-fold (p < 0.001) and 36-fold higher (p < 0.001), respectively.CONCLUSIONS: Tumor size and year of surgery are independent predictors of PN in our cohort. Our data exemplify the adoption of PN for RCC in tertiary care centers in Austria and Germany in line with implemented guideline changes. The utilization of PN has increased over time regardless of surgical approach. Further studies need to address the use of robot-assisted surgery and care in community hospitals.
AB - OBJECTIVE: To compare the trends of partial nephrectomy (PN) and radical nephrectomy (RN) in 2 European tertiary referral centers with regards to guideline changes.MATERIALS AND METHODS: A total of 1,573 patients who underwent RN or PN for localized (≤T2) renal cell carcinoma (RCC) were included. Logistic regression analyses assessed the predictors of PN and laparoscopy over time.RESULTS: Out of the total, 1,013 patients (65.6%) were treated with RN and 560 patients (34.4%) with PN. Also, 1,233 patients (80%) had open surgery whereas 340 patients (22%) were treated with a laparoscopic approach. Laparoscopic RN and PN were performed in 216 (13.7%) and 124 (7.8%) patients, respectively. T1b tumors were 73% less likely (p < 0.001) to be treated with PN compared to T1a tumors. The odds of undergoing PN or laparoscopy in 2008-2010 relative to 2000-2001 were 6.5-fold (p < 0.001) and 36-fold higher (p < 0.001), respectively.CONCLUSIONS: Tumor size and year of surgery are independent predictors of PN in our cohort. Our data exemplify the adoption of PN for RCC in tertiary care centers in Austria and Germany in line with implemented guideline changes. The utilization of PN has increased over time regardless of surgical approach. Further studies need to address the use of robot-assisted surgery and care in community hospitals.
KW - Adult
KW - Aged
KW - Aged, 80 and over
KW - Austria
KW - Carcinoma, Renal Cell
KW - Cohort Studies
KW - Databases, Factual
KW - Female
KW - Germany
KW - Humans
KW - Kidney Neoplasms
KW - Laparoscopy
KW - Male
KW - Middle Aged
KW - Nephrectomy
KW - Nephrons
KW - Practice Guidelines as Topic
KW - Referral and Consultation
KW - Regression Analysis
KW - Robotic Surgical Procedures
KW - Journal Article
KW - Multicenter Study
U2 - 10.1159/000442215
DO - 10.1159/000442215
M3 - SCORING: Journal article
C2 - 26699625
VL - 96
SP - 330
EP - 336
JO - UROL INT
JF - UROL INT
SN - 0042-1138
IS - 3
ER -