Abstract：
INTRODUCTION:The "trifecta" is a summary measure of outcome after partial nephrectomy (PN) that encompasses three parameters: negative surgical margin, ≤ 10% decrease in post-operative estimated glomerular filtration rate (eGFR) and absence of urological complications. We assessed trifecta rates in patients undergoing open (OPN), laparoscopic (LPN), and robotic PN (RPN) for a clinical T1 renal mass (≤ 7 cm). METHODS:Clinical and pathologic parameters were extracted from the prospectively maintained Canadian Kidney Cancer Information System for patients treated between January 2011 and October 2018. Comparisons between groups were made using Kruskal-Wallis test for continuous variables and Chi-squared independence test for categorical variables. Multivariable analysis was performed to identify predictors of each component of the trifecta and the trifecta itself. RESULTS:Of 1708 total patients, 746 underwent OPN, 678 LPN, and 284 RPN for a T1 renal mass. A 'trifecta' was achieved in 53% OPN, 52% LPN and 47% RPN (p = 0.194). On multivariable analysis, OPN and LPN were associated with less frequent post-operative decline in eGFR and more frequent trifecta when compared to RPN, but there was no difference between OPN and LPN. OPN also predicted a higher rate of negative margins compared to RPN but not LPN. CONCLUSION:After correction for confounding variables, OPN and LPN were more likely than RPN to achieve the trifecta, which appeared to be due primarily to loss of renal function. No difference was observed between OPN and LPN. Analyses were limited by the lack of nephrometry score.
journal_name
World J Uroljournal_title
World journal of urologyauthors
Ghavimi S,Saarela O,Pouliot F,Rendon RA,Finelli A,Kapoor A,Moore RB,Breau RH,Lavallee L,Lacombe L,Fairey A,Jewett M,Liu Z,Tanguay S,Black PCdoi
10.1007/s00345-020-03349-ysubject
Has Abstractpub_date
2020-07-12 00:00:00eissn
0724-4983issn
1433-8726pii
10.1007/s00345-020-03349-ypub_type
杂志文章abstract：:Although immediate radical cystectomy remains the standard of care for invasive bladder cancer, a large body of international experience from single institutions and cooperative groups has accumulated, suggesting favorable results with bladder-sparing approaches in appropriately selected patients. Modern selective bla...
journal_title：World journal of urology
pub_type： 杂志文章,评审
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journal_title：World journal of urology
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pub_type： 杂志文章,meta分析
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