Giacomo Novara1, Sabrina La Falce1, Ronney Abaza2, James Adshead3, Rajesh Ahlawat4, Nicolò Maria Buffi5, Ben Challacombe6, Prokar Dasgupta6, Daniel A Moon7, Dipen J Parekh8, Francesco Porpiglia9, Sudhir Rawal10, Craig Rogers11, Alessandro Volpe12, Mahendra Bhandari11, Alexander Mottrie13,14. 1. Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy. 2. Department of Urology, Ohio Health Dublin Methodist Hospital, Dublin, OH, USA. 3. Hertfordshire and South Bedfordshire Urological Cancer Centre, Lister Hospital, Stevenage, UK. 4. Division of Urology and Renal Transplantation, Medanta Kidney and Urology Institute, Medanta, the Medicity, Gurgaon, India. 5. Humanitas Clinical and Research Center, Rozzano, Milan, Italy. 6. MRC Centre for Transplantation, King's College London, London, UK. 7. Peter MacCallum Cancer Centre, Melbourne, Vic., Australia. 8. University of Miami Miller School of Medicine and Sylvestor Comprehensive Cancer Center, Miami, FL, USA. 9. San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy. 10. Rajiv Gandhi Cancer Hospital, New Delhi, India. 11. Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA. 12. University of Eastern Piedmont, Novara, Italy. 13. Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium. 14. OLV Vattikuti Robotic Surgery Institute, Aalst, Belgium.
Abstract
OBJECTIVE: To evaluate the outcomes of robot-assisted partial nephrectomy (RAPN) in cystic tumours, analysing a large, multi-institutional, retrospective series of RAPN, as limited data are available about the outcome of RAPN in cystic tumours. PATIENTS AND METHODS: We evaluated 465 patients who received RAPN for either cystic or solid tumours from 2010 to 2013 and included in the multi-institutional, retrospective Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI-RUS) database. Univariable and multivariable linear and logistic regression models addressed the association of cystic tumours with perioperative outcomes. RESULTS: In all, 54 (12%) tumours were cystic. Cystic tumours were associated with significantly lower operative time (t -3.9; P < 0.001), once adjusted for the effect of covariates, whereas blood loss and warm ischaemia time were similar. Postoperative any grade complications were recorded in 66 solid (16%) and nine cystic (17%) tumours (P = 0.08). In multivariable analysis, cystic tumours were not associated with a significantly lower risk of any grade postoperative complications [odds ratio (OR) 0.9; P = 0.8]. Similarly, presence of tumours with cystic features was not associated with a significantly different risk of high-grade postoperative complications (OR 2.2; P = 0.1). Prevalence of cancer histology and positive surgical margin rates were similar in cystic and solid tumours. Cystic tumours were not associated with significantly different postoperative estimated glomerular filtration rate (t 0.4; P = 0.7), once adjusted for the effect of covariates. CONCLUSIONS: RAPN can be performed in cystic renal tumours with perioperative, pathological, and functional outcomes similar to those achievable in solid tumours.
OBJECTIVE: To evaluate the outcomes of robot-assisted partial nephrectomy (RAPN) in cystic tumours, analysing a large, multi-institutional, retrospective series of RAPN, as limited data are available about the outcome of RAPN in cystic tumours. PATIENTS AND METHODS: We evaluated 465 patients who received RAPN for either cystic or solid tumours from 2010 to 2013 and included in the multi-institutional, retrospective Vattikuti Global Quality Initiative in Robotic Urologic Surgery (GQI-RUS) database. Univariable and multivariable linear and logistic regression models addressed the association of cystic tumours with perioperative outcomes. RESULTS: In all, 54 (12%) tumours were cystic. Cystic tumours were associated with significantly lower operative time (t -3.9; P < 0.001), once adjusted for the effect of covariates, whereas blood loss and warm ischaemia time were similar. Postoperative any grade complications were recorded in 66 solid (16%) and nine cystic (17%) tumours (P = 0.08). In multivariable analysis, cystic tumours were not associated with a significantly lower risk of any grade postoperative complications [odds ratio (OR) 0.9; P = 0.8]. Similarly, presence of tumours with cystic features was not associated with a significantly different risk of high-grade postoperative complications (OR 2.2; P = 0.1). Prevalence of cancer histology and positive surgical margin rates were similar in cystic and solid tumours. Cystic tumours were not associated with significantly different postoperative estimated glomerular filtration rate (t 0.4; P = 0.7), once adjusted for the effect of covariates. CONCLUSIONS: RAPN can be performed in cystic renal tumours with perioperative, pathological, and functional outcomes similar to those achievable in solid tumours.
Authors: Giovanni Di Lascio; Alessandro Sciarra; Francesco Del Giudice; Stefano Salciccia; Gian Maria Busetto; Ettore De Berardinis; Gian Piero Ricciuti; Daniele Castellani; Giacomo Maria Pirola; Martina Maggi; Alessandro Gentilucci; Susanna Cattarino; Gianna Mariotti; Paolo Casale; Giovanni Battista Di Pierro Journal: Cent European J Urol Date: 2022-01-12