A systematic review of robot-assisted partial nephrectomy outcomes for advanced indications: Large tumors (cT2-T3), solitary kidney, completely endophytic, hilar, recurrent, and multiple renal tumors

Pandolfo, Savio Domenico; Cerrato, Clara; Wu, Zhenjie; Franco, Antonio; Del Giudice, Francesco; Sciarra, Alessandro; Verze, Paolo; Lucarelli, Giuseppe; Imbimbo, Ciro; Perdonà, Sisto; Cherullo, Edward E.; Porpiglia, Francesco; Derweesh, Ithaar H.; Autorino, Riccardo

doi:10.1016/j.ajur.2023.06.001

Cited by 19 publications

(6 citation statements)

References 112 publications

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“…A meta-analysis involving 467 patients suggests that immune combination therapy significantly reduces mortality and disease progression compared to sunitinib treatment ( 15 ). Robot-assisted partial nephrectomy (RAPN) is currently utilized in the treatment of renal cell carcinoma, showing promising results ( 16 ). Hanif’s retrospective study also shows that therapy with immune checkpoint inhibitors (CPI) offers superior outcomes compared to conventional treatments using molecular targeted drugs or chemotherapy ( 17 ).…”

Section: Discussionmentioning

confidence: 99%

Case report: Sarcomatoid renal cell carcinoma masquerading as hydronephrosis

Chen,

He,

Meng

et al. 2024

Front. Oncol.

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Sarcomatoid renal cell carcinoma (SRCC), a manifestation of sarcomatoid dedifferentiation in renal cell carcinoma, is characterized by elevated invasiveness and a grim prognosis. Typically, SRCC patients present with advanced or metastatic conditions and survival rates rarely extend beyond one year. In this study, we describe a case of SRCC characterized by the patient exhibiting right flank pain without hematuria. Initially, imaging interpretations led to a diagnosis of severe hydronephrosis. Subsequently, an open right nephrectomy post-surgery confirmed the pathology of sarcomatoid renal cell carcinoma.

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Section: Discussionmentioning

confidence: 99%

Case report: Sarcomatoid renal cell carcinoma masquerading as hydronephrosis

Chen,

He,

Meng

et al. 2024

Front. Oncol.

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“…The primary objective of PN is to achieve complete removal of the tumor with clear surgical boundaries, while also minimizing global WIT and optimizing preoperative eGFR [66][67][68]. These three factors have been shown to be important predictors of postoperative renal function following RAPN [14,20]. Moreover, recent tools have been developed to predict renal function outcomes post-surgery in order to improve patient management and guide decision-making in RCC-challenging settings [69,70].…”

Section: Clamping Techniques For Renal Hilar Massesmentioning

confidence: 99%

“…In the current literature, there is a recognition of the unique challenges presented by renal hilar masses, primarily due to their close proximity to blood vessels and the collecting system, coupled with the absence or scarcity of a parenchymal margin near the renal hilum [20,47]. Furthermore, these tumors are recognized in certain studies as a risk factor for the progression of the tumor stage from T1 to T3a, primarily because of this closeness to the renal sinus fat and vasculature [86,87].…”

Section: Resection Techniques For Renal Hilar Massesmentioning

confidence: 99%

“…More specifically, hilar location is as a key feature defining tumor complexity [17][18][19]. Indeed, hilar masses represent intricate tumors, often characterized by their proximity to the main renal artery or vein, and/or the renal pelvis on preoperative computed tomography scans [20,21]. These situations present significant challenges for the urologist [22,23].…”

Section: Introductionmentioning

confidence: 99%

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Outcomes and Techniques of Robotic-Assisted Partial Nephrectomy (RAPN) for Renal Hilar Masses: A Comprehensive Systematic Review

Pandolfo,

Wu,

Campi

et al. 2024

Cancers

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Background: Robot-assisted partial nephrectomy (RAPN) is increasingly being employed in the management of renal cell carcinoma (RCC) and it is expanding in the field of complex renal tumors. The aim of this systematic review was to consolidate and assess the results of RAPN when dealing with entirely central hilar masses and to examine the various methods used to address the surgical difficulties associated with them. Methods: A thorough literature search in September 2023 across various databases focused on RAPN for renal hilar masses, adhering to PRISMA guidelines. The primary goal was to evaluate RAPN’s surgical and functional outcomes, with a secondary aim of examining different surgical techniques. Out of 1250 records, 13 full-text manuscripts were reviewed. Results: Evidence is growing in favor of RAPN for renal hilar masses. Despite a predominance of retrospective studies and a lack of long-term data, RAPN shows positive surgical outcomes and preserves renal function without compromising cancer treatment effectiveness. Innovative suturing and clamping methods are emerging in surgical management. Conclusions: RAPN is a promising technique for managing renal hilar masses in RCC, offering effective surgical outcomes and renal function preservation. The study highlights the need for more long-term data and prospective studies to further validate these findings.

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“…Various strategies are applicable for managing clinically localized SRMs with suspected RCC, including active surveillance, ablation therapy, and surgery (Figure 1) [6]. Current guidelines endorse nephron-sparing surgery (NSS), such as partial nephrectomy (PN), for managing SRMs when technically feasible [2,7]. However, it is widely recognized that SRMs usually are low-grade, slow-progressing tumors with limited metastatic potential [8,9].…”

Section: Introductionmentioning

confidence: 99%

Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review

Aveta,

Iossa,

Spena

et al. 2024

Life

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This review focuses on ablative techniques for small renal masses (SRMs), including radiofrequency ablation (RFA), cryoablation (CA), microwave ablation (MWA), and irreversible electroporation (IRE), and discusses recurrence management. Through an extensive literature review, we outline the procedures, outcomes, and follow-up strategies associated with each ablative method. The review provides a detailed examination of these techniques—RFA, CA, MWA, and IRE—elucidating their respective outcomes. Recurrence rates vary among them, with RFA and CA showing comparable rates, MWA demonstrating favorable short-term results, and IRE exhibiting promise in experimental stages. For managing recurrences, various strategies are considered, including active surveillance, re-ablation, or salvage surgery. Surveillance is preferred post-RFA and post-CA, due to slow SRM growth, while re-ablation, particularly with RFA and CA, is deemed feasible without additional complications. Salvage surgery emerges as a viable option for larger or resistant tumors. While ablative techniques offer short-term results comparable to surgery, further research is essential to understand their long-term effects fully. Decisions concerning recurrence management should consider individual and tumor-specific factors. Imaging, notably contrast-enhanced ultrasounds, plays a pivotal role in assessing treatment success, emphasizing the necessity of a multidisciplinary approach for optimal outcomes. The lack of randomized trials highlights the need for further research.

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A systematic review of robot-assisted partial nephrectomy outcomes for advanced indications: Large tumors (cT2-T3), solitary kidney, completely endophytic, hilar, recurrent, and multiple renal tumors

Cited by 19 publications

References 112 publications

Case report: Sarcomatoid renal cell carcinoma masquerading as hydronephrosis

Case report: Sarcomatoid renal cell carcinoma masquerading as hydronephrosis

Outcomes and Techniques of Robotic-Assisted Partial Nephrectomy (RAPN) for Renal Hilar Masses: A Comprehensive Systematic Review

Ablative Treatments for Small Renal Masses and Management of Recurrences: A Comprehensive Review

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