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Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group

Standard

Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group. / Bindayi, Ahmet; Autorino, Riccardo; Capitanio, Umberto; Pavan, Nicola; Mir, Maria Carmen; Antonelli, Alessandro; Takagi, Toshio; Bertolo, Riccardo; Maurer, Tobias; Ho Rha, Koon; Long, Jean Alexandre; Yang, Bo; Schips, Luigi; Lima, Estevão; Breda, Alberto; Linares, Estefania; Celia, Antonio; De Nunzio, Cosimo; Dobbs, Ryan; Patel, Sunil; Hamilton, Zachary; Tracey, Andrew; Larcher, Alessandro; Trombetta, Carlo; Palumbo, Carlotta; Tanabe, Kazunari; Amiel, Thomas; Raheem, Ali; Fiard, Gaelle; Zhang, Chao; Castellucci, Roberto; Palou, Joan; Ryan, Stephen; Crivellaro, Simone; Montorsi, Francesco; Porpiglia, Francesco; Derweesh, Ithaar H.

in: EUR UROL FOCUS, Jahrgang 6, Nr. 5, 15.09.2020, S. 982-990.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Bindayi, A, Autorino, R, Capitanio, U, Pavan, N, Mir, MC, Antonelli, A, Takagi, T, Bertolo, R, Maurer, T, Ho Rha, K, Long, JA, Yang, B, Schips, L, Lima, E, Breda, A, Linares, E, Celia, A, De Nunzio, C, Dobbs, R, Patel, S, Hamilton, Z, Tracey, A, Larcher, A, Trombetta, C, Palumbo, C, Tanabe, K, Amiel, T, Raheem, A, Fiard, G, Zhang, C, Castellucci, R, Palou, J, Ryan, S, Crivellaro, S, Montorsi, F, Porpiglia, F & Derweesh, IH 2020, 'Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group', EUR UROL FOCUS, Jg. 6, Nr. 5, S. 982-990. https://doi.org/10.1016/j.euf.2019.02.010

APA

Bindayi, A., Autorino, R., Capitanio, U., Pavan, N., Mir, M. C., Antonelli, A., Takagi, T., Bertolo, R., Maurer, T., Ho Rha, K., Long, J. A., Yang, B., Schips, L., Lima, E., Breda, A., Linares, E., Celia, A., De Nunzio, C., Dobbs, R., ... Derweesh, I. H. (2020). Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group. EUR UROL FOCUS, 6(5), 982-990. https://doi.org/10.1016/j.euf.2019.02.010

Vancouver

Bindayi A, Autorino R, Capitanio U, Pavan N, Mir MC, Antonelli A et al. Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group. EUR UROL FOCUS. 2020 Sep 15;6(5):982-990. https://doi.org/10.1016/j.euf.2019.02.010

Bibtex

@article{adec7ca2a3df4eccbcf1e62151571171,
title = "Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group",
abstract = "BACKGROUND: Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes.OBJECTIVE: To evaluate quality and functional outcomes of PN in patients >75 yr using trifecta as a composite outcome of surgical quality.DESIGN, SETTING, AND PARTICIPANTS: Multicenter retrospective analysis of 653 patients aged >75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group).INTERVENTION: PN.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes.RESULTS AND LIMITATIONS: We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo; 382 open, 157 laparoscopic, and 114 robotic). Trifecta rate was 40.4% (n=264). Trifecta patients had less transfusion (p<0.001), lower intraoperative (5.3% vs 27%, p<0.001) and postoperative (25.4% vs 37.8%, p=0.001) complications, shorter hospital stay (p=0.045), and lower ΔeGFR (p <0.001). MVA for predictive factors for trifecta revealed decreasing RENAL nephrometry score (odds ratio [OR] 1.26, 95% confidence interval 1.07-1.51, p=0.007) as being associated with increased likelihood to achieve trifecta. Achievement of trifecta was associated with decreased risk of CKD upstaging (OR 0.47, 95% confidence interval 0.32-0.62, p<0.001). KMA showed that trifecta patients had improved 5-yr freedom from CKD stage 3 (93.5% vs 57.7%, p<0.001) and CKD upstaging (84.3% vs 8.2%, p<0.001). Limitations include retrospective design.CONCLUSIONS: PN in elderly patients can be performed with acceptable quality outcomes. Trifecta was associated with decreased tumor complexity and improved functional preservation.PATIENT SUMMARY: We looked at quality outcomes after partial nephrectomy in elderly patients. Acceptable quality outcomes were achieved, measured by a composite outcome called trifecta, whose achievement was associated with improved kidney functional preservation.",
author = "Ahmet Bindayi and Riccardo Autorino and Umberto Capitanio and Nicola Pavan and Mir, {Maria Carmen} and Alessandro Antonelli and Toshio Takagi and Riccardo Bertolo and Tobias Maurer and {Ho Rha}, Koon and Long, {Jean Alexandre} and Bo Yang and Luigi Schips and Estev{\~a}o Lima and Alberto Breda and Estefania Linares and Antonio Celia and {De Nunzio}, Cosimo and Ryan Dobbs and Sunil Patel and Zachary Hamilton and Andrew Tracey and Alessandro Larcher and Carlo Trombetta and Carlotta Palumbo and Kazunari Tanabe and Thomas Amiel and Ali Raheem and Gaelle Fiard and Chao Zhang and Roberto Castellucci and Joan Palou and Stephen Ryan and Simone Crivellaro and Francesco Montorsi and Francesco Porpiglia and Derweesh, {Ithaar H}",
note = "Copyright {\textcopyright} 2019. Published by Elsevier B.V.",
year = "2020",
month = sep,
day = "15",
doi = "10.1016/j.euf.2019.02.010",
language = "English",
volume = "6",
pages = "982--990",
journal = "EUR UROL FOCUS",
issn = "2405-4569",
publisher = "Elsevier BV",
number = "5",

}

RIS

TY - JOUR

T1 - Trifecta Outcomes of Partial Nephrectomy in Patients Over 75 Years Old: Analysis of the REnal SURGery in Elderly (RESURGE) Group

AU - Bindayi, Ahmet

AU - Autorino, Riccardo

AU - Capitanio, Umberto

AU - Pavan, Nicola

AU - Mir, Maria Carmen

AU - Antonelli, Alessandro

AU - Takagi, Toshio

AU - Bertolo, Riccardo

AU - Maurer, Tobias

AU - Ho Rha, Koon

AU - Long, Jean Alexandre

AU - Yang, Bo

AU - Schips, Luigi

AU - Lima, Estevão

AU - Breda, Alberto

AU - Linares, Estefania

AU - Celia, Antonio

AU - De Nunzio, Cosimo

AU - Dobbs, Ryan

AU - Patel, Sunil

AU - Hamilton, Zachary

AU - Tracey, Andrew

AU - Larcher, Alessandro

AU - Trombetta, Carlo

AU - Palumbo, Carlotta

AU - Tanabe, Kazunari

AU - Amiel, Thomas

AU - Raheem, Ali

AU - Fiard, Gaelle

AU - Zhang, Chao

AU - Castellucci, Roberto

AU - Palou, Joan

AU - Ryan, Stephen

AU - Crivellaro, Simone

AU - Montorsi, Francesco

AU - Porpiglia, Francesco

AU - Derweesh, Ithaar H

N1 - Copyright © 2019. Published by Elsevier B.V.

PY - 2020/9/15

Y1 - 2020/9/15

N2 - BACKGROUND: Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes.OBJECTIVE: To evaluate quality and functional outcomes of PN in patients >75 yr using trifecta as a composite outcome of surgical quality.DESIGN, SETTING, AND PARTICIPANTS: Multicenter retrospective analysis of 653 patients aged >75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group).INTERVENTION: PN.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes.RESULTS AND LIMITATIONS: We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo; 382 open, 157 laparoscopic, and 114 robotic). Trifecta rate was 40.4% (n=264). Trifecta patients had less transfusion (p<0.001), lower intraoperative (5.3% vs 27%, p<0.001) and postoperative (25.4% vs 37.8%, p=0.001) complications, shorter hospital stay (p=0.045), and lower ΔeGFR (p <0.001). MVA for predictive factors for trifecta revealed decreasing RENAL nephrometry score (odds ratio [OR] 1.26, 95% confidence interval 1.07-1.51, p=0.007) as being associated with increased likelihood to achieve trifecta. Achievement of trifecta was associated with decreased risk of CKD upstaging (OR 0.47, 95% confidence interval 0.32-0.62, p<0.001). KMA showed that trifecta patients had improved 5-yr freedom from CKD stage 3 (93.5% vs 57.7%, p<0.001) and CKD upstaging (84.3% vs 8.2%, p<0.001). Limitations include retrospective design.CONCLUSIONS: PN in elderly patients can be performed with acceptable quality outcomes. Trifecta was associated with decreased tumor complexity and improved functional preservation.PATIENT SUMMARY: We looked at quality outcomes after partial nephrectomy in elderly patients. Acceptable quality outcomes were achieved, measured by a composite outcome called trifecta, whose achievement was associated with improved kidney functional preservation.

AB - BACKGROUND: Partial nephrectomy (PN) in elderly patients is underutilized with concerns regarding risk of complications and potential for poor outcomes.OBJECTIVE: To evaluate quality and functional outcomes of PN in patients >75 yr using trifecta as a composite outcome of surgical quality.DESIGN, SETTING, AND PARTICIPANTS: Multicenter retrospective analysis of 653 patients aged >75 yr who underwent PN (REnal SURGery in Elderly [RESURGE] Group).INTERVENTION: PN.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Primary outcome was achievement of trifecta (negative margin, no major [Clavien ≥3] urological complications, and ≥90% estimated glomerular filtration rate [eGFR] recovery). Secondary outcomes included chronic kidney disease (CKD) stage III and CKD upstaging. Multivariable analysis (MVA) was used to assess variables for achieving trifecta and functional outcomes. Kaplan-Meier survival analysis (KMA) was used to calculate renal functional outcomes.RESULTS AND LIMITATIONS: We analyzed 653 patients (mean age 78.4 yr, median follow-up 33 mo; 382 open, 157 laparoscopic, and 114 robotic). Trifecta rate was 40.4% (n=264). Trifecta patients had less transfusion (p<0.001), lower intraoperative (5.3% vs 27%, p<0.001) and postoperative (25.4% vs 37.8%, p=0.001) complications, shorter hospital stay (p=0.045), and lower ΔeGFR (p <0.001). MVA for predictive factors for trifecta revealed decreasing RENAL nephrometry score (odds ratio [OR] 1.26, 95% confidence interval 1.07-1.51, p=0.007) as being associated with increased likelihood to achieve trifecta. Achievement of trifecta was associated with decreased risk of CKD upstaging (OR 0.47, 95% confidence interval 0.32-0.62, p<0.001). KMA showed that trifecta patients had improved 5-yr freedom from CKD stage 3 (93.5% vs 57.7%, p<0.001) and CKD upstaging (84.3% vs 8.2%, p<0.001). Limitations include retrospective design.CONCLUSIONS: PN in elderly patients can be performed with acceptable quality outcomes. Trifecta was associated with decreased tumor complexity and improved functional preservation.PATIENT SUMMARY: We looked at quality outcomes after partial nephrectomy in elderly patients. Acceptable quality outcomes were achieved, measured by a composite outcome called trifecta, whose achievement was associated with improved kidney functional preservation.

U2 - 10.1016/j.euf.2019.02.010

DO - 10.1016/j.euf.2019.02.010

M3 - SCORING: Journal article

C2 - 30799289

VL - 6

SP - 982

EP - 990

JO - EUR UROL FOCUS

JF - EUR UROL FOCUS

SN - 2405-4569

IS - 5

ER -