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Multicenter Study
. 2023 Mar;41(3):747-755.
doi: 10.1007/s00345-023-04279-1. Epub 2023 Mar 1.

Partial or radical nephrectomy for complex renal mass: a comparative analysis of oncological outcomes and complications from the ROSULA (Robotic Surgery for Large Renal Mass) Collaborative Group

Clara Cerrato  1   2 , Devin Patel  1 , Riccardo Autorino  3   4 , Giuseppe Simone  5 , Bo Yang  6 , Robert Uzzo  7 , Francesco Porpiglia  8 , Umberto Capitanio  9 , James Porter  10 , Alp Tuna Beksac  11 , Andrea Minervini  12 , Alessandro Antonelli  2 , Maria Angela Cerruto  2 , Clayton Lau  13 , Akbar Ashrafi  14 , Daniel Eun  15 , Alexandre Mottrie  16 , Carmen Mir  17 , Margaret F Meagher  1 , Dhruv Puri  1 , Mimi Nguyen  1 , Sohail Dhanji  1 , Franklin Liu  1 , Savio D Pandolfo  3 , Alexander Kutikov  7 , Francesco Montorsi  9 , Inderbir S Gill  14 , Chandru Sundaram  18 , Jihad Kaouk  11 , Ithaar H Derweesh  19
Affiliations
Multicenter Study

Partial or radical nephrectomy for complex renal mass: a comparative analysis of oncological outcomes and complications from the ROSULA (Robotic Surgery for Large Renal Mass) Collaborative Group

Clara Cerrato et al. World J Urol. 2023 Mar.

Abstract

Purpose: To compare outcomes of robotic-assisted partial nephrectomy (RAPN) and minimally invasive radical nephrectomy (MIS-RN) for complex renal masses (CRM).

Methods: We conducted a retrospective multicenter analysis of CRM patients who underwent MIS-RN and RAPN. CRM was defined as RENAL score 10-12. Primary outcome was overall survival (OS). Secondary outcomes were cancer-specific survival (CSS), recurrence, and complications. Multivariable analysis (MVA) and Kaplan-Meier Analysis (KMA) were used to analyze functional and survival outcomes for RN vs. PN by pathological stage.

Results: 926 patients were analyzed (MIS-RN = 437/RAPN = 489; median follow-up 24.0 months). MVA demonstrated lack of transfusion (HR = 1.63, p = 0.005), low-grade (HR = 1.18, p = 0.018) and smaller tumor size (HR = 1.05, p < 0.001) were associated with OS. Younger age (HR = 1.01, p = 0.017), high-grade (HR = 1.18, p = 0.017), smaller tumor size (HR = 1.05, p < 0.001), and lack of transfusion (HR = 1.39, p = 0.038) were associated with CSS. Increasing tumor size (HR = 1.18, p < 0.001), high-grade (HR = 3.21, p < 0.001), and increasing age (HR = 1.02, p = 0.009) were independent risk factors for recurrence. Type of surgery was not associated with major complications (p = 0.094). For KMA of MIS-RN vs. RAPN for pT1, pT2 and pT3, 5-year OS was 85% vs. 88% (p = 0.078); 82% vs. 80% (p = 0.442) and 84% vs. 83% (p = 0.863), respectively. 5-year CSS was 98% for both procedures (p = 0.473); 94% vs. 92% (p = 0.735) and 91% vs. 90% (p = 0.581). 5-year non-CSS was 87% vs. 93% (p = 0.107); 87% for pT2 (p = 0.485) and 92% for pT3 for both procedures (p = 0.403).

Conclusion: RAPN in CRM is not associated with increased risk of complications or worsened oncological outcomes when compared to MIS-RN and may be preferred when clinically indicated.

Keywords: Carcinoma; Complex renal mass; Complications; Partial nephrectomy; Radical nephrectomy; Renal Cell; Survival analysis.

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References

    1. Ljungberg B, Albiges L, Abu-Ghanem Y et al (2022) European Association of Urology Guidelines on renal cell carcinoma: the 2022 update. Eur Urol 82:399–410 - DOI - PubMed
    1. Campbell SC, Clark PE, Chang SS et al (2021) Renal mass and localized renal cancer: evaluation, management, and follow-up: AUA guideline: part I. J Urol. https://doi.org/10.1097/JU.0000000000001911 - DOI - PubMed
    1. Mir MC, Derweesh I, Porpiglia F et al (2017) Partial nephrectomy versus radical nephrectomy for clinical T1b and T2 renal tumors: a systematic review and meta-analysis of comparative studies. Eur Urol 71:606–671 - DOI - PubMed
    1. Patel SH, Uzzo RG, Larcher A et al (2020) Oncologic and functional outcomes of radical and partial nephrectomy in pT3a pathologically upstaged renal cell carcinoma: a multi-institutional analysis. Clin Genitourin Cancer. https://doi.org/10.1016/j.clgc.2020.05.002 - DOI - PubMed - PMC
    1. Yim K, Aron M, Rha KH et al (2021) Outcomes of robot-assisted partial nephrectomy for clinical T3a renal masses: a multicenter analysis. Eur Urol Focus. https://doi.org/10.1016/j.euf.2020.10.011 - DOI - PubMed

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