Outcomes of Robot-assisted Partial Nephrectomy for Clinical T2 Renal Tumors: A Multicenter Analysis (ROSULA Collaborative Group)

Bertolo, Riccardo; Autorino, Riccardo; Simone, Giuseppe; Derweesh, Ithaar; Garisto, Juan; Minervini, Andrea; Eun, Daniel; Perdonà, Sisto; Porter, James; Rha, Koon Ho; Mottrie, Alexander; White, Wesley M.; Schips, Luigi; Yang, Bo; Jacobsohn, Kenneth; Uzzo, Robert G.; Challacombe, Ben; Ferro, Matteo; Sulek, Jay; Capitanio, Umberto; Anele, Uzoma A.; Tuderti, Gabriele; Costantini, Manuela; Ryan, Stephen; Bindayı, Ahmet; Carini, Marco; Keehn, Aryeh; Quarto, Giuseppe; Liao, Michael Z.; Chang, Kidon; Larcher, Alessandro; Naeyer, Geert De; Cobelli, O. De; Berardinelli, Francesco; Zhang, Chao; Langenstroer, Peter; Kutikov, Alexander; Chen, David; Luyk, Nicolò De; Sundaram, Chandru P.; Montorsi, Francesco; Stein, Robert J.; Haber, Georges Pascal; Hampton, Lance J.; Dasgupta, Prokar; Gallucci, Michele; Porpiglia, Francesco

doi:10.1016/j.eururo.2018.05.004

Cited by 125 publications

(80 citation statements)

References 38 publications

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“…Today, this paradigm is changing, and MIS, especially robotic surgery, has been shown to be safe and feasible even for large and complex renal tumors. Data from the ROSULA Collaborative Group demonstrated robotic PN to be feasible for large renal masses, maximizing kidney function without compromising on oncological outcomes [73]. Despite the encouraging data regarding NSS for T1b-T2 tumors [74], RN is recommended when PN is not feasible [1], and our data demonstrated the role of the nephrometry score during preoperative planning.…”

Section: Discussionmentioning

confidence: 70%

Predictive Value of Nephrometry Scores in Nephron-sparing Surgery: A Systematic Review and Meta-analysis

Veccia

Antonelli

Uzzo

et al. 2020

European Urology Focus

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Context: Over the last decade, several nephrometry scores (NSs) have been introduced with the aim of facilitating preoperative decision making, planning, and counseling in the field of nephron-sparing surgery. However, their predictive role remains controversial. Objective: To describe currently available nephrometry scores and to determine their predictive role for different outcomes by performing a systematic review and metaanalysis of the literature. Evidence acquisition: PubMed, Embase1, and Web of Science were screened to identify eligible studies. Identification and selection of the reports were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). A pooled analysis of NS predictive role of intraoperative, postoperative, oncological, and functional outcomes was performed. Odds ratio was considered the effect size. All the analyses were performed using Stata 15.0, and statistical significance was set at p 0.05. Evidence synthesis: Overall, 51 studies meeting our inclusion criteria were identified and considered for the analysis. Except for one prospective randomized trial, all the studies were retrospective. All the studies were found to be of intermediate quality, except for one of high quality. Most studies assessed the predictive role of the Radius-Exophytic/Endophytic-Nearness-Anterior/Posterior-Location (RENAL) and Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) scores, mostly regarding complications after nephron-sparing surgery. RENAL was an independent predictor of an on-clamp procedure (p < 0.001). Mayo Adhesive Probability score was related to adhesive perinephric fat (p = 0.005). Continuous and high-complexity RENAL scores were predictors of warm ischemia time (WIT; p = 0.006 and p < 0.001, respectively). Continuous (p < 0.001) and high-complexity (p < 0.001) PADUA scores were related to WIT. Continuous and high-complexity RENAL scores were predictors of overall complications (p = 0.002 and p < 0.001, respectively). PADUA score was related to complications both as continuous (p < 0.001) and as a categorical value (p < 0.002). The RENAL scores R = 3 (p = 0.008), E = 2 (p = 0.039), and hilar location (p = 0.006) were predictors of histological malignancy. Continuous and categorical RENAL scores were independent

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Section: Discussionmentioning

confidence: 70%

Predictive Value of Nephrometry Scores in Nephron-sparing Surgery: A Systematic Review and Meta-analysis

Veccia

Antonelli

Uzzo

et al. 2020

European Urology Focus

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“…Indeed, the surgical feasibility of PN in patients with cT1b disease has been reported by several authors [16,17]. A recent report suggests that PN should not compromise the oncological outcome in patients with >7 cm renal tumours even when performed with a robot-assisted approach [18]. However, most of the surgical series comparing PN with RN reported a significantly higher blood loss and complication rate in patients treated by PN [19][20][21][22].…”

Section: Discussionmentioning

confidence: 98%

Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

et al. 2019

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nomogram for predicting the risk of postoperative surgical complications. At decision curve analysis, the nomogram led to superior outcomes for any decision associated with a threshold probability of >5%. ConclusionSeveral clinical predictors have been associated with postoperative surgical complications after PN. We used this information to develop and internally validate a nomogram to predict such risk.

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“…While we agree in the validity of this criticism, there nonetheless exists a subset of patients in whom a safe and efficacious nephron-sparing procedure or locally advanced resection is truly not be feasible, and with even mild cytoreduction, feasibility and efficacy of such a resection may be enhanced. The senior author of this manuscript bases his opinion on the fact that he has one of the largest series in the literature of large partial nephrectomies 6 Journal of Oncology (>7cm) performed, whether by open approach [62,63] or by minimally invasive approach [64]. We recently also demonstrated efficacy of primary systemic therapy prior to nephrectomy with IVC thrombectomy [65] and believe that our results and those emerging from other groups suggest that concept of primary cytoreductive systemic therapy has merit should be investigated further.…”

Section: Neoadjuvant Therapy In the Management Of Localized Rcc: Futumentioning

confidence: 99%

Current Status of Immunotherapy for Localized and Locally Advanced Renal Cell Carcinoma

Ghali

Patel

Derweesh

2019

Journal of Oncology

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Systemic therapy strategies in the setting of localized and locally advanced renal cell carcinoma (RCC) have continued to evolve in two directions: as adjuvant therapy (to reduce risk of recurrence or progression in high risk localized groups), or as neoadjuvant therapy as a strategy to render primary renal tumors amenable to planned surgical resection in settings where radical resection or nephron-sparing surgery was not thought to be safe or feasible. In the realm of adjuvant therapy, the results of phase III randomized clinical trials have been mixed and contradictory; nonetheless based on the findings of the landmark S-TRAC study, the tyrosine kinase inhibitor Sunitinib has been approved as an adjuvant agent in the United States. In the realm of neoadjuvant therapy, presurgical tumor reduction has been demonstrated in a number of phase II studies utilizing targeted molecular agents. The advent of immunomodulation through checkpoint inhibition as first line therapy for metastatic RCC represents an exciting horizon for adjuvant and neoadjuvant strategies. This article reviews the current status and future prospects of adjuvant and neoadjuvant immunotherapy in localized and locally advanced RCC.

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Outcomes of Robot-assisted Partial Nephrectomy for Clinical T2 Renal Tumors: A Multicenter Analysis (ROSULA Collaborative Group)

Abstract: This report shows that robotic surgery can be used for safe removal of a large renal tumor in a minimally invasive fashion, maximizing preservation of renal function, and without compromising cancer control.

Cited by 125 publications

References 38 publications

Predictive Value of Nephrometry Scores in Nephron-sparing Surgery: A Systematic Review and Meta-analysis

Predictive Value of Nephrometry Scores in Nephron-sparing Surgery: A Systematic Review and Meta-analysis

Nomogram for predicting the likelihood of postoperative surgical complications in patients treated with partial nephrectomy: a prospective multicentre observational study (the RECORd 2 project)

Current Status of Immunotherapy for Localized and Locally Advanced Renal Cell Carcinoma

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