Abstract:
OBJECTIVE:To compare outcomes of minimally invasive radical nephrectomy (MIS-RN) and robot-assisted partial nephrectomy (RAPN) in clinical T2a renal mass (cT2aRM). PATIENTS AND METHODS:Retrospective, multicentre, propensity score-matched (PSM) comparison of RAPN and MIS-RN for cT2aRM (T2aN0M0). Cohorts were PSM for age, sex, body mass index, American Society of Anesthesiologists (ASA) class, clinical tumour size, and R.E.N.A.L. score using a 2:1 ratio for RN:PN. The primary outcome was disease-free survival (DFS). Secondary outcomes included overall survival (OS), complication rates, and de novo estimated glomerular filtration rate (eGFR) <45 mL/min/1.73 m2 . Multivariable (MVA) and Kaplan-Meier survival analyses (KMSA) were conducted. RESULTS:In all, 648 patients (216 RAPN/432 MIS-RN) were matched. There were no significant differences in intraoperative complications (P = 0.478), Clavien-Dindo Grade ≥III complications (P = 0.063), and re-admissions (P = 0.238). The MVA revealed high ASA class (hazard ratio [HR] 2.7, P = 0.044) and sarcomatoid (HR 5.3, P = 0.001), but not surgery type (P = 0.601) to be associated with all-cause mortality. Increasing R.E.N.A.L. score (HR 1.31, P = 0.037), high tumour grade (HR 2.5, P = 0.043), and sarcomatoid (HR 2.8, P = 0.02) were associated with recurrence, but not surgery (P = 0.555). Increasing age (HR 1.1, P < 0.001) and RN (HR 3.9, P < 0.001) were predictors of de novo eGFR of <45 mL/min/1.73 m2 . Comparing RAPN and MIS-RN, KMSA revealed no significant differences for 5-year OS (76.3% vs 88.0%, P = 0.221) and 5-year DFS (78.6% vs 85.3%, P = 0.630) for pT2 RCC, and no differences for 3-year OS (P = 0.351) and 3-year DFS (P = 0.117) for pT3a upstaged RCC. The 5-year freedom from de novo eGFR of <45 mL/min/1.73 m2 was 91.6% for RAPN vs 68.9% for MIS-RN (P < 0.001). CONCLUSIONS:RAPN had similar oncological outcomes and morbidity profile as MIS-RN, while conferring functional benefit. RAPN may be considered as a first-line option for cT2aRM.
journal_name
BJU Intjournal_title
BJU internationalauthors
Bradshaw AW,Autorino R,Simone G,Yang B,Uzzo RG,Porpiglia F,Capitanio U,Porter J,Bertolo R,Minervini A,Lau C,Jacobsohn K,Ashrafi A,Eun D,Mottrie A,White WM,Schips L,Challacombe BJ,De Cobelli O,Mir CM,Veccia A,Lardoi
10.1111/bju.15064subject
Has Abstractpub_date
2020-07-01 00:00:00pages
114-123issue
1eissn
1464-4096issn
1464-410Xjournal_volume
126pub_type
杂志文章,多中心研究abstract::• Synthetic mid-urethral slings (MUSs) are considered the first choice surgical procedure for stress urinary incontinence. Recent publications have raised concerns about the efficacy of third generation single-incision mini-slings. The present paper is a systematic review of studies reporting 12-month outcomes after t...
journal_title:BJU international
pub_type: 杂志文章,评审
doi:10.1111/j.1464-410X.2011.10333.x
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abstract:OBJECTIVE:• To compare outcomes of hilar clamping and non-hilar clamping partial nephrectomy for tumours involving a solitary functional kidney. PATIENTS AND METHODS:• Between 1990 and 2009, 104 partial nephrectomies, excluding bench and autotransplant procedures, were performed on solitary functional kidneys. • An in...
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journal_title:BJU international
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1464-4096.2001.01817.x
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pub_type: 杂志文章
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更新日期:2004-01-01 00:00:00
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更新日期:1999-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-10-01 00:00:00
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pub_type: 杂志文章
doi:10.1046/j.1464-410x.2000.00914.x
更新日期:2000-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-09-01 00:00:00
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07698.x
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journal_title:BJU international
pub_type: 杂志文章
doi:10.1111/j.1464-410X.2008.07513.x
更新日期:2008-05-01 00:00:00
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pub_type: 杂志文章,评审
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pub_type: 杂志文章,多中心研究
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更新日期:2008-06-01 00:00:00
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更新日期:2007-03-01 00:00:00
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pub_type: 杂志文章,多中心研究
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更新日期:2010-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2007-03-01 00:00:00
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更新日期:2007-07-01 00:00:00
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更新日期:2005-12-01 00:00:00
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更新日期:2014-11-01 00:00:00