Robot-assisted partial nephrectomy: 7-year outcomes.
Umberto Carbonara,Giuseppe Simone,Umberto Capitanio,Andrea Minervini,Cristian Fiori,Alessandro Larcher,Enrico Checcucci,Daniele Amparore,Fabio Crocerossa,Alessandro Veccia,Samuel Weprin,Pasquale Ditonno,Aldo Brassetti,A.M. Bove,Andrea Mari,Antonio Andrea Grosso,Marco Carini,Francesco Montorsi,Lance J. Hampton,Michele Gallucci,Francesco Porpiglia,Riccardo Autorino +21 more
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TL;DR: The findings show excellent 7-year oncologic and functional outcomes of patients who underwent RAPN for a malignant mass with a median follow-up of 7-yr, the longest following-up to date.
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Abstract: BACKGROUND The role of robot-assisted partial nephrectomy (RAPN) in the management of renal masses has exponentially grown over the past 10 years. Nevertheless, data on long term outcomes of the procedure remains limited. Herein we report oncological and functional outcomes of patients who underwent RAPN for a malignant mass with a median follow-up of 7 years, the longest follow-up to date. METHODS A retrospective analysis of an international multicenter database was performed. All consecutive patients undergoing surgery between 2009 and 2013 with a minimum of 3-year follow-up and complete data on renal function were included. Demographics, surgical and perioperative outcomes were analyzed. Overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were evaluated using Kaplan-Meier analysis. RESULTS Overall, our study cohort was composed of eighty-five patients with a median follow-up of 88 months. Median clinical tumor size was 3 cm, with mostly (74.1%) clinical stage T1a, and median RENAL score 6. Final histopathologic analysis revealed clear cell RCC in 76.5% of cases. PSM was present in seven patients (8.2%). Eleven overall deaths (12.9%) occurred in the cohort during the follow-up period. Two of these (2.33%) were attributed to metastatic RCC. The OS, CSS, and DFS rates were 91.7%, 97.7%, and 91.7% at 84 months, respectively. Regarding the renal functional outcomes, seventeen patients (20.1%) presented a CKD upstaging in our cohort. CONCLUSIONS Our findings show excellent 7-year oncologic and functional outcomes of the procedure, which duplicate those achieved in historical series of open and laparoscopic surgery.
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Citations
The IRON Study: Investigation of Robot-assisted Versus Open Nephron-sparing Surgery
01 Mar 2023
TL;DR: In this article , a comparative study on robotic versus open partial nephrectomy, functional and oncologic outcomes were similar between the two techniques, with lower morbidity-especially in terms of complications-for robot-assisted surgery.
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A systematic review of robotic partial nephrectomy outcomes for advanced indications: Large (cT2-T3), solitary kidney, completely endophytic, hilar, recurrent, and multiple renal tumors
S. Pandolfo,Clara Cerrato,Zhenjie Wu,Antonio Franco,Francesco Del Giudice,Alessandro Sciarra,Paolo Verze,Giuseppe Lucarelli,Ciro Imbimbo,Sisto Perdonà,Edward E. Cherullo,Francesco Porpiglia,Ithaar Derweesh,Riccardo Autorino +13 more
TL;DR: Over the past decade, evidence supporting the use of RAPN for the most challenging nephron-sparing surgery indications has continuously grown and is associated with favorable surgical outcomes with good preservation of renal function without compromising the oncological result.
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Retroperitoneal versus transepritoneal robot-assisted partial nephrectomy for postero-lateral renal masses: an international multicenter analysis.
Umberto Carbonara,Daniel Eun,Ithaar Derweesh,Umberto Capitanio,Antonio Celia,Cristian Fiori,Enrico Checcucci,Daniele Amparore,Jennifer J. Lee,Alessandro Larcher,Devin Patel,Margaret Meagher,Fabio Crocerossa,Alessandro Veccia,Lance J. Hampton,Francesco Montorsi,Francesco Porpiglia,Riccardo Autorino +17 more
TL;DR: In this paper, the outcomes of robot-assisted partial nephrectomy (RAPN) in a large cohort of patients with postero-lateral renal masses comparing to those of transperitoneal RAPN (t-RAPNs) were assessed.
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Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review
TL;DR: Takeaway is that RAPN deliver similar oncologic performance to OPN and LPN, and data coming from retrospective and prospective series shows very good oncological outcomes after RAPn.
New Generation of 3D Virtual Models with Perfusional Zones: Perioperative Assistance for the Best Pedicle Management during Robotic Partial Nephrectomy
Daniele Amparore,Federico Piramide,P. Verri,Enrico Checcucci,Sabrina De Cillis,Alberto Piana,Gabriele Volpi,M Burgio,G. Busacca,Marco Colombo,Cristian Fiori,Francesco Porpiglia +11 more
TL;DR: In this article , a new generation of 3D-virtual models (3DVMs) were introduced, which consider the perfusion volumes of the kidney, and a selective clamping strategy was designed and intraoperatively performed based on the specifically generated 3DVM.
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Functional and oncological outcomes of open, laparoscopic and robot-assisted partial nephrectomy: a multicentre comparative matched-pair analyses with a median of 5 years’ follow-up
Ki Don Chang,Ali Abdel Raheem,Ali Abdel Raheem,Kwang Hyun Kim,Cheol Kyu Oh,Sung Yul Park,Young-Sik Kim,Won Sik Ham,Woong Kyu Han,Young Deuk Choi,Byung Ha Chung,Koon Ho Rha +11 more
TL;DR: To compare outcomes at a 5‐year median follow-up among different partial nephrectomy approaches: robot‐assisted (RAPN), laparoscopic (LPN) and open partial ne phrectomy (OPN) is compared.
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Robot-assisted Partial Nephrectomy for Complex (PADUA Score ≥10) Tumors: Techniques and Results from a Multicenter Experience at Four High-volume Centers.
Nicolò Maria Buffi,Alberto Saita,Giovanni Lughezzani,James Porter,Paolo Dell'Oglio,Daniele Amparore,Cristian Fiori,Geert Denaeyer,Francesco Porpiglia,Alex Mottrie +9 more
TL;DR: It is demonstrated that, in experienced hands, RAPN is a feasible and safe treatment option even in patients with complex renal tumors, and increasing tumor complexity may affect the surgical outcomes in this highly selected patient population.
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Robot-assisted versus open partial nephrectomy: comparison of outcomes. A systematic review.
Nikolaos Grivas,Nikolaos Kalampokis,Alessandro Larcher,Stavros I. Tyritzis,Stavros I. Tyritzis,Koon Ho Rha,Vincenzo Ficarra,Nicolò Buffi,Achilles Ploumidis,Riccardo Autorino,Francesco Porpiglia,Henk G. van der Poel,Alexandre Mottrie,Geert De Naeyer,J-Erus +14 more
TL;DR: Current evidence demonstrate that RAPN is a reasonable alternative to OPN with regard to oncological and early functional outcomes with a straightforward advantage of improved perioperative morbidity, as expected by minimally invasive techniques.
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