Comparison of Robot-Assisted Laparoscopic Partial Nephrectomy with Laparoscopic Cryoablation in the Treatment of Localised Renal Tumours: A Propensity Score-Matched Comparison of Long-Term Outcomes

Liu, Huiying; Kang, Chih Hsiung; Wang, Hung-Jen; Chen, Chien-Hsu; Luo, Hao; Chen, Yen-Ta; Cheng, Yufang; Chiang, Po‐Hui

doi:10.3390/diagnostics11050759

Cited by 7 publications

(3 citation statements)

References 19 publications

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“…After fulfilling all the inclusion criteria, 13 studies were identified [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], and another 17 studies were excluded mainly because follow-up was too short [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. All of the studies had an retrospective design except the ones from Furukawa et al [ 16 ] and Beauval et al [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Vartolomei

Remzi

Fajković

et al. 2022

JCM

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Background: Robot-assisted partial nephrectomy (RAPN) is used more and more in present days as a therapy option for surgical treatment of cT1 renal masses. Current guidelines equally recommend open (OPN), laparoscopic (LPN), or robotic partial nephrectomy (PN). The aim of this review was to analyze the most representative RAPN series in terms of reported oncological outcomes. (2) Methods: A systematic search of Webofscience, PUBMED, Clinicaltrials.gov was performed on 1 August 2022. Studies were considered eligible if they: included patients with renal cell carcinoma (RCC) stage T1, were prospective, used randomized clinical trials (RCT) or retrospective studies, had patients undergo RAPN with a minimum follow-up of 48 months. (3) Results: Reported positive surgical margin rates were from 0 to 10.5%. Local recurrence occurred in up to 3.6% of patients. Distant metastases were reported in up to 6.4% of patients. 5-year cancer free survival (CFS) estimates rates ranged from 86.4% to 98.4%. 5-year cancer specific survival (CSS) estimates rates ranged from 90.1% to 100%, and 5-year overall survival (OS) estimates rated ranged from 82.6% to 97.9%. (4) Conclusions: Data coming from retrospective and prospective series shows very good oncologic outcomes after RAPN. Up to now, 10-year survival outcomes were not reported. Taken together, RAPN deliver similar oncologic performance to OPN and LPN.

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Section: Resultsmentioning

confidence: 99%

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Vartolomei

Remzi

Fajković

et al. 2022

JCM

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“…We included 13 studies ( 11 , 15 – 17 , 20 , 22 , 24 , 25 , 27 , 28 , 31 , 32 , 35 ) about EBL. Compared with MIPN, patients who underwent FT had significantly less EBL (SMD, −0.90; CI, −1.26 to −0.53; I 2 = 92.2%, P < 0.0001) ( Figure 2C ).…”

Section: Resultsmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Minimally Invasive Partial Nephrectomy Versus Focal Therapy for Small Renal Masses

Dong¹,

Liang²,

Ya³

et al. 2022

Front. Oncol.

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BackgroundMinimally invasive partial nephrectomy (MIPN) and focal therapy (FT) are popular trends for small renal masses (SRMs). However, there is currently no systematic comparison between MIPN and FT of SRMs. Therefore, we systematically study the perioperative, renal functional, and oncologic outcomes of MIPN and FT in SRMs.MethodsWe have searched the Embase, Cochrane Library, and PubMed for articles between MIPN (robot-assisted partial nephrectomy and laparoscopic partial nephrectomy) and FT {radiofrequency ablation (RFA), microwave ablation (MWA), cryoablation (CA), irreversible electroporation, non-thermal [irreversible electroporation (IRE)] ablation, and stereotactic body radiation therapy (SBRT)}. We calculated pooled mean difference (MD), odds ratios (ORs), and 95% confidence intervals (CIs) (CRD42021260787).ResultsA total of 26 articles (n = 4,420) were included in the study. Compared with MIPN, the operating time (OP) of FT had significantly lower (SMD, −1.20; CI, −1.77 to −0.63; I2 = 97.6%, P < 0.0001), estimated blood loss (EBL) of FT had significantly less (SMD, −1.20; CI, −1.77 to −0.63; I2 = 97.6%, P < 0.0001), length of stay (LOS) had shorter (SMD, −0.90; CI, −1.26 to −0.53; I2 = 92.2%, P < 0.0001), and estimated glomerular filtration rate (eGFR) of FT was significantly lower decrease (SMD, −0.90; CI, −1.26 to −0.53; I2 = 92.2%, P < 0.0001). However, FT possessed lower risk in minor complications (Clavien 1–2) (OR, 0.69; CI, 0.45 to 1.07; I2 = 47%, P = 0.023) and overall complications (OR, 0.71; CI, 0.51 to 0.99; I2 = 49.2%, P = 0.008). Finally, there are no obvious difference between FT and MIPN in local recurrence, distant metastasis, and major complications (P > 0.05).ConclusionFT has more advantages in protecting kidney function, reducing bleeding, shortening operating time, and shortening the length of stay. There is no difference in local recurrence, distant metastasis, and major complications. For the minimally invasive era, we need to weigh the advantages and disadvantages of all aspects to make comprehensive choices.Systematic Review Registrationhttps://www.crd.york.ac.uk/PROSPERO/#recordDetails, identifier PROSPERO (CRD42021260787).

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“…Irreversible electroporation is based on a strong, short-pulsed electromagnetic field that is applied to the tissue and causes the trans-membrane potential to increase. Membrane permeability becomes irreversible when the transmembrane potential exceeds a certain threshold, resulting in cell apoptosis and necrosis [ 32 ]. This approach is not affected by the heat sink and tissue desiccation and provides greater geometric predictability for ablation and allows the sparing of the connective tissue architecture, with consequent minimal risk of damage to the adjacent healthy structures.…”

Section: Vascular and Non-vascular Approachesmentioning

confidence: 99%

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

Floridi

Cellina

Irmici

et al. 2022

JCM

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Interventional oncology (IO) procedures have become extremely popular in interventional radiology (IR) and play an essential role in the diagnosis, treatment, and supportive care of oncologic patients through new and safe procedures. IR procedures can be divided into two main groups: vascular and non-vascular. Vascular approaches are mainly based on embolization and concomitant injection of chemotherapeutics directly into the tumor-feeding vessels. Percutaneous approaches are a type of non-vascular procedures and include percutaneous image-guided biopsies and different ablation techniques with radiofrequency, microwaves, cryoablation, and focused ultrasound. The use of these techniques requires precise imaging pretreatment planning and guidance that can be provided through different imaging techniques: ultrasound, computed tomography, cone-beam computed tomography, and magnetic resonance. These imaging modalities can be used alone or in combination, thanks to fusion imaging, to further improve the confidence of the operators and the efficacy and safety of the procedures. This article aims is to provide an overview of the available IO procedures based on clinical imaging guidance to develop a targeted and optimal approach to cancer patients.

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Comparison of Robot-Assisted Laparoscopic Partial Nephrectomy with Laparoscopic Cryoablation in the Treatment of Localised Renal Tumours: A Propensity Score-Matched Comparison of Long-Term Outcomes

Cited by 7 publications

References 19 publications

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

A Systematic Review and Meta-Analysis of Minimally Invasive Partial Nephrectomy Versus Focal Therapy for Small Renal Masses

Precision Imaging Guidance in the Era of Precision Oncology: An Update of Imaging Tools for Interventional Procedures

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