Trifecta and pentafecta outcomes following robot-assisted partial nephrectomy in a multi-institutional cohort of Indian patients

Sharma, Gopal; Shah, Milap; Ahluwalia, P. K.; Bhandari, Mahendra; Ahlawat, Rajesh; Rawal, Sudhir; Sivaraman, Ananthakrishnan; Thyavihally, Y.; Gautam, Gagan

doi:10.4103/iju.iju_238_22

Cited by 4 publications

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Predictive factors for pentafecta achievement in robot‐assisted partial nephrectomy for intermediate highly complex RENAL tumors (RENAL score ≥ 7)

Uemura,

Ito,

Ikeda

et al. 2023

Int J of Urology

View full text Add to dashboard Cite

ObjectivesTo investigate the predictive factors for pentafecta achievement of robot‐assisted partial nephrectomy (RAPN) for intermediate highly complex renal tumors (RENAL score ≥ 7).MethodsWe retrospectively analyzed the data of 247 patients with renal tumors with a RENAL score ≥ 7 who underwent RAPN. Baseline characteristics and perioperative outcomes were compared between the pentafecta achieved group and the unachieved group. A multivariable logistic regression model was used to identify the predictive factors for pentafecta achievement for cT1 renal tumors with a RENAL score ≥ 7.ResultsOf the 247 patients, 75 (30.3%) patients were in the achieved group and 172 (69.7%) patients were in the unachieved group. The median warm ischemia time and total operation time were 18 min versus 23 min (p < 0.001) and 179 min versus 201 min (p < 0.001) in the achieved and unachieved groups, respectively. In the unachieved group, six patients (3.4%) had major perioperative complications (Clavien–Dindo classification system ≥3). The median preservation rates of estimated GFR at the 1‐year postoperative period were 96.5% versus 83.0% (p < 0.001) in the achieved and unachieved groups. Multivariable logistic regression models revealed that age and tumor size were independent predictive factors for pentafecta achievement for cT1 renal tumors with a RENAL score ≥ 7. There were no significant differences in cancer‐free survival between the two groups (p = 0.456).ConclusionAge and tumor size were independent predictive factors for pentafecta achievement, although there was no difference in oncological outcomes between the pentafecta achieved group and the unachieved group in RAPN for cT1 renal tumors with a RENAL score ≥ 7.

show abstract

Predictive factors for pentafecta achievement in robot‐assisted partial nephrectomy for intermediate highly complex RENAL tumors (RENAL score ≥ 7)

Uemura,

Ito,

Ikeda

et al. 2023

Int J of Urology

View full text Add to dashboard Cite

show abstract

Assessing pentafecta outcomes post radical cystectomy: A tertiary care center study

Singh,

Sarangi,

Bhirud

et al. 2023

Urologia

View full text Add to dashboard Cite

Introduction: Bladder cancer is a common and serious disease globally, often requiring radical cystectomy as the preferred treatment. However, this procedure carries substantial risks and complications. To evaluate its success, pentafecta, a five-component measure, was introduced. This study investigates the attainment of pentafecta following radical cystectomy and examines factors that influence its achievement. Methodology: This retrospective, single-group study was conducted at AIIMS Jodhpur. The study population included 42 patients who underwent radical cystectomy for bladder cancer. Various data, including demographic characteristics, clinical features, surgical techniques, and postoperative outcomes, were collected from medical records. The primary outcome measure was the rate of achieving pentafecta, which comprises five parameters. Results: Out of 42 patients, 26 (61.9%) achieved pentafecta. Age, gender, comorbidities and surgical approach did not significantly affect the attainment of pentafecta. Negative surgical margins were achieved in 95.2% of cases, and adequate lymph node dissection (>16 lymph nodes) was performed in 85.7% of cases. The absence of Clavien-Dindo grade 3–5 complications and recurrence was observed in 80.9% and 90.47% of cases, respectively. Uretero-enteric stricture was absent in 95.2% of cases. Conclusion: The study emphasizes the significance of negative surgical margins, thorough lymph node dissection, absence of complications, recurrence, and uretero-enteric strictures in evaluating the success of radical cystectomy as pentafacta outcomes. Patients with higher drain output and wound infections are less likely to achieve pentafacta outcome and indicates poorer outcome. By considering these factors, clinicians can assess patient outcomes and identify areas for improvement.

show abstract

Comparative Analysis of Trifecta and Pentafecta Outcomes in T1a and T1b Renal Tumors Following Robotic Partial Nephrectomy: A Retrospective Study

Sharma,

Mohan

et al. 2024

Preprint

View full text Add to dashboard Cite

Purpose: This study aims to conduct a comparative analysis of Trifecta and Pentafecta outcomes between T1a and T1b renal tumors in patients undergoing robotic partial nephrectomy (RAPN). We explore the influence of clinical factors, including the RENAL nephrometry score components, on these outcomes. Methods: A retrospective multicentre study was conducted on 133 patients who underwent RAPN for T1a (n = 51) and T1b (n = 82) renal tumors between 2017 and 2023. We assessed Trifecta and Pentafecta outcomes, and statistical comparisons were made. Univariate and multivariate analyses were conducted to evaluate the impact of tumor size and RENAL components on these outcomes. Results: Trifecta was achieved in 74.5% of T1a tumors and 68.3% of T1b tumors (p = 0.429). Pentafecta outcomes were achieved in 56.9% of T1a and 47.6% of T1b tumors (p = 0.297). Warm ischemia time was significantly longer in T1b tumors (p = 0.037). In the univariate analysis, warm ischemia time and tumor size were significant predictors of Trifecta and Pentafecta outcomes, respectively. Nearness to the collecting system was also a significant factor in univariate analysis (p = 0.045). Other clinical factors such as exophytic/endophytic properties and location relative to polar lines did not significantly impact outcomes. Conclusion: RAPN is equally effective for T1a and T1b renal tumors, providing comparable Trifecta and Pentafecta outcomes. Warm ischemia time, tumor size, and nearness to the collecting system are important factors influencing these outcomes.

show abstract

Trifecta and pentafecta outcomes following robot-assisted partial nephrectomy in a multi-institutional cohort of Indian patients

Cited by 4 publications

References 45 publications

Predictive factors for pentafecta achievement in robot‐assisted partial nephrectomy for intermediate highly complex RENAL tumors (RENAL score ≥ 7)

Predictive factors for pentafecta achievement in robot‐assisted partial nephrectomy for intermediate highly complex RENAL tumors (RENAL score ≥ 7)

Assessing pentafecta outcomes post radical cystectomy: A tertiary care center study

Comparative Analysis of Trifecta and Pentafecta Outcomes in T1a and T1b Renal Tumors Following Robotic Partial Nephrectomy: A Retrospective Study

Contact Info

Product

Resources

About