Literature DB >> 30630732

National trends and disparities of minimally invasive surgery for localized renal cancer, 2010 to 2015.

Leilei Xia1, Ruchika Talwar2, Benjamin L Taylor3, Michael H Shin4, Ian B Berger2, Colin D Sperling5, Raju R Chelluri2, Ibardo A Zambrano2, Jay D Raman6, Thomas J Guzzo2.   

Abstract

PURPOSE: To investigate national utilization trends of minimally-invasive partial nephrectomy (PN) and minimally-invasive radical nephrectomy (RN), and to identify disparities in the usage of these techniques across different sociodemographic subgroups.
MATERIALS AND METHODS: A retrospective cohort study was conducted using the National Cancer Database to identify patients undergoing partial or RN for cT1N0M0 renal cancer diagnosed between 2010 and 2015. Main outcomes of interest were the utilizations of minimally-invasive (robotic and laparoscopic) PN and RN.
RESULTS: A total of 46,346 and 37,712 subjects who underwent PN and RN, respectively, were analyzed. During the study interval, increased utilization of robotic surgery paralleled the decreased utilization of open surgery. Robotic PN increased from 35.2% to 63.7% and robotic RN increased from 10.3% to 26.3%. The utilization of laparoscopic surgery was decreasing for PN but stable for RN through the study period. In the PN cohort, multivariable logistic regression showed non-Hispanic black (odds ratio [OR] = 0.90 [95% CI, 0.84-0.96]) and Hispanic (OR = 0.91 [0.84-0.99]) subjects were associated with less utilization of minimally invasive surgery (MIS) (vs. non-Hispanic white). Younger (18-64 years) Medicare (OR = 0.83 [0.77-0.90]), Medicaid (OR = 0.80 [0.74-0.87]), and uninsured (OR = 0.55 [0.49-0.62]) were also associated with less utilization of MIS (vs. private insurance). Compared with low socioeconomic status (SES), upper middle (OR = 1.14 [1.07-1.21]) and high (OR = 1.24 [1.16-1.33]) SES were associated with higher utilization of MIS. Similar demographic, insurance, and SES-related disparities were identified in the RN cohort.
CONCLUSIONS: Utilization of MIS for localized renal cancer has increased significantly and was mainly attributed to increased usage of robotic surgery. Racial/ethnic, insurance, and SES related disparities in MIS utilization were identified. Our findings demonstrate a targetable subgroup of patients who do not have the same access to advances in surgical technology.
Copyright © 2018. Published by Elsevier Inc.

Entities:  

Keywords:  Laparoscopy; Minimally invasive; Nephrectomy; Renal cancer; Robotics

Mesh:

Year:  2019        PMID: 30630732     DOI: 10.1016/j.urolonc.2018.10.028

Source DB:  PubMed          Journal:  Urol Oncol        ISSN: 1078-1439            Impact factor:   3.498


  6 in total

1.  Sociodemographic and behavioral characteristics associated with blood donation in the United States: a population-based study.

Authors:  Eshan U Patel; Evan M Bloch; Mary K Grabowski; Ruchika Goel; Parvez M Lokhandwala; Patricia A R Brunker; Jodie L White; Beth Shaz; Paul M Ness; Aaron A R Tobian
Journal:  Transfusion       Date:  2019-06-20       Impact factor: 3.157

2.  Factors Associated With Receipt of Partial Nephrectomy or Minimally Invasive Surgery for Patients With Clinical T1a and T1b Renal Masses: Implications for Regionalization of Care.

Authors:  Joshua Sterling; Zorimar Rivera-Núñez; Hiren V Patel; Nicholas J Farber; Sinae Kim; Kushan D Radadia; Parth K Modi; Sharad Goyal; Rahul Parikh; Robert E Weiss; Isaac Y Kim; Sammy E Elsamra; Thomas L Jang; Eric A Singer
Journal:  Clin Genitourin Cancer       Date:  2020-03-20       Impact factor: 2.872

3.  Effect of Socio-Economic Status on Perioperative Outcomes After Robotic-Assisted Pulmonary Lobectomy.

Authors:  Anastasia Jermihov; Liwei Chen; Maria F Echavarria; Emily P Ng; Frank O Velez; Carla C Moodie; Joseph R Garrett; Jacques P Fontaine; Eric M Toloza
Journal:  Cureus       Date:  2022-06-22

4.  Are there disparities in access to robot-assisted laparoscopic surgery among pediatric urology patients? US institutional experience.

Authors:  Amrita Mohanty; Alyssa M Lombardo; Clark Judge; Mohan S Gundeti
Journal:  Int J Urol       Date:  2022-03-26       Impact factor: 2.896

5.  Editorial: Optimizing surgical procedures in renal cancers to improve patient outcomes.

Authors:  Hiten D Patel; Arnav Srivastava
Journal:  Front Oncol       Date:  2022-09-27       Impact factor: 5.738

6.  Minimally Invasive Partial Nephrectomy in the Era of Robotic Surgery.

Authors:  Hakan Bahadir Haberal; Meylis Artykov; Ahmet Gudeloglu; Sertac Yazici; Cenk Yucel Bilen
Journal:  Sisli Etfal Hastan Tip Bul       Date:  2021-07-02
  6 in total

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