Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: a matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project)

Minervini, Andrea; Siena, Giampaolo; Antonelli, Alessandro; Bianchi, Giampaolo; Bocciardi, Aldo Massimo; Cunico, S. Cosciani; Ficarra, Vincenzo; Fiori, Cristian; Fusco, Ferdinando; Martorana, Giuseppe; Medica, M.; Mirone, Vincenzo; Morgia, Giuseppe; Porpiglia, Francesco; Rocco, Francesco; Rovereto, B.; Schiavina, Riccardo; Simeone, Claudio; Terrone, Carlo; Volpe, Alessandro; Carini, Marco; Serni, Sergio

doi:10.1007/s00345-013-1155-7

Cited by 53 publications

(56 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…SE), appear to be unrelated to margins status, according to the largest currently available evidence. 7,[14][15][16][17][18] We aimed to evaluate the predictors of PSM after NSS for RCC in one of the largest available prospective multi-institutional studies.…”

Section: Introductionmentioning

confidence: 99%

A Prospective, Multicenter Evaluation of Predictive Factors for Positive Surgical Margins After Nephron-Sparing Surgery for Renal Cell Carcinoma: The RECORd1 Italian Project

Schiavina

Serni

Mari

et al. 2015

Clinical Genitourinary Cancer

Self Cite

View full text Add to dashboard Cite

The early oncological goal of any partial nephrectomy (PN) is to achieve negative surgical margins (SMs). Several factors have been advocated as predictors of positive SMs (PSMs) after nephron-sparing surgery (NSS). In our study, age, upper pole tumor location, standard PN and Fuhrman 3/4 nuclear grade were found to be independent predictors of PSMs at multivariable analysis. Further evaluations are required to verify the oncological effect of the PSM on local and systemic recurrence. Background: The purpose of this study was to evaluate the predictors of positive margins in one of the largest available prospective multi-institutional studies. Patients and Methods: We evaluated all patients who underwent NSS for radiologically diagnosed kidney tumors between January 2009 and December 2012 at 19 urological Italian centers (Registry of Conservative Renal Surgery [RECORd] project). Preoperative and anthropometric data, comorbidities, intraoperative and postoperative outcomes, and histological findings were analyzed. The negative and PSMs were compared according to the clinical and surgical variables. Multivariable logistic regression models were applied to analyze predictors of PSMs. Results: Eight hundred consecutive patients were evaluated. Seven hundred sixty-one (95.1%) and 39 patients (4.9%) achieved negative and PSMs, respectively. Patients with PSMs were significantly older compared with those with negative margins (median age: 66.6 vs. 61.8 years, respectively; P ¼ .001). A higher incidence of PSMs was observed when NSS was performed for renal masses located in the upper pole (P ¼ .001). A lower rate of PSMs was found in patients treated with simple enucleation rather than standard PN (1.6% vs. 7.4%, respectively; P < .0001). A greater incidence of PSMs was found in Fuhrman 3/4 tumors (11.3%; P < .0001). At multivariable analysis, age (odds ratio [OR], 1.04; P ¼ .01), upper pole tumor location (OR, 2.85; P ¼ .005), standard PN (OR, 3.45; P ¼ .004), and Fuhrman 3-4 nuclear grade (OR, 4.81; P ¼ .001) were found to be independent predictors of PSMs. Conclusion: In our multi-institutional report, young age, simple enucleation, middle or lower tumor location, and low-grade tumor were demonstrated to be independent predictors of negative SMs.

show abstract

Section: Introductionmentioning

confidence: 99%

A Prospective, Multicenter Evaluation of Predictive Factors for Positive Surgical Margins After Nephron-Sparing Surgery for Renal Cell Carcinoma: The RECORd1 Italian Project

Schiavina

Serni

Mari

et al. 2015

Clinical Genitourinary Cancer

Self Cite

View full text Add to dashboard Cite

show abstract

“…A study has shown that each 1cm increase in tumour size increased the chances of not achieving the trifecta twofold. 26 The trifecta unites three important principles of PN, which are individually associated with better prognosis and may increasingly be used to assess surgeon and centre level oncological outcomes.…”

mentioning

confidence: 99%

Prediction of complications after partial nephrectomy by RENAL nephrometry score

Reddy

Pillai

Parker

et al. 2014

annals

View full text Add to dashboard Cite

INTRODUCTION Discussing and planning the appropriate management for suspicious renal masses can be challenging. With the development of nephrometry scoring methods, we aimed to evaluate the ability of the RENAL nephrometry score to predict both the incidence of postoperative complications and the change in renal function after a partial nephrectomy. METHODS This was a retrospective study including 128 consecutive patients who underwent a partial nephrectomy (open and laparoscopic) for renal lesions in a tertiary UK referral centre. Univariate and multivariate ordinal regression models were used to identify associations between Clavien-Dindo classification and explanatory variables. The Kendall rank correlation coefficient was used to examine an association between RENAL nephrometry score and a drop in estimated glomerular filtration rate (eGFR) following surgery. RESULTS An increase in the RENAL nephrometry score of one point resulted in greater odds of being in a higher Clavien-Dindo classification after controlling for RENAL suffix and type of surgical procedure (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.04-1.64, p=0.043). Furthermore, a patient with the RENAL suffix 'p' (ie posterior location of tumour) had increased odds of developing more serious complications (OR: 2.60, 95% CI: 1.07-6.30, p=0.042). A correlation was shown between RENAL nephrometry score and postoperative drop in eGFR (Kendall's tau coefficient -0.24, p=0.004). CONCLUSIONS To our knowledge, this is the first study that has shown the predictive ability of the RENAL nephrometry scoring system in a UK cohort both in terms of postoperative complications and change in renal function.

show abstract

“…The trifecta rate in the Ploussard study significantly dropped to 64.3% after the first 20 cases, similarly to those reported by other open or laparoscopic skilled teams. 12,13 This result is encouraging, and emphasizes the safety and feasibility of the robotic approach in partial nephrectomy. We believe that surgeon experience, rather than the surgical technique, is the decisive and foremost factor affecting oncological and functional outcomes after partial nephrectomy.…”

Section: 9mentioning

confidence: 75%

Robot-assisted partial nephrectomy: Excellent results even in more complex renal tumours

Borghesi

Schiavina

Martorana

et al. 2014

CUAJ

Self Cite

View full text Add to dashboard Cite

show abstract

Open versus laparoscopic partial nephrectomy for clinical T1a renal masses: a matched-pair comparison of 280 patients with TRIFECTA outcomes (RECORd Project)

Cited by 53 publications

References 32 publications

A Prospective, Multicenter Evaluation of Predictive Factors for Positive Surgical Margins After Nephron-Sparing Surgery for Renal Cell Carcinoma: The RECORd1 Italian Project

A Prospective, Multicenter Evaluation of Predictive Factors for Positive Surgical Margins After Nephron-Sparing Surgery for Renal Cell Carcinoma: The RECORd1 Italian Project

Prediction of complications after partial nephrectomy by RENAL nephrometry score

Robot-assisted partial nephrectomy: Excellent results even in more complex renal tumours

Contact Info

Product

Resources

About