Kazuhiko Yoshida1, Tsunenori Kondo2, Junpei Iizuka3, Hironori Fukuda3, Hiroki Ishihara2, Hirohito Kobayashi2, Masayoshi Okumi4, Hideki Ishida3, Kazunari Tanabe3, Toshio Takagi3. 1. Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. kzyoshida1@yahoo.co.jp. 2. Department of Urology, Tokyo Women's Medical University Adachi Medical Center, 4-33-1 Kouhoku, Adachi-ku, Tokyo, Japan. 3. Department of Urology, Tokyo Women's Medical University, 8-1 Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan. 4. Department of Urology, Osaka Police Hospital, 10-31 Kitayama-cho,Tennnoji, Osaka, Japan.
Abstract
BACKGROUND: Cancer development in adolescents and young adults (AYAs) has elicited recent interest. We investigated the surgical and functional outcomes of robot-assisted laparoscopic partial nephrectomy (RAPN) for renal cell carcinoma (RCC) in AYAs. METHODS: We retrospectively reviewed the medical records of 1023 patients with clinical stage I RCC who underwent RAPN before January 2021. Patients were divided into two groups: AYAs (aged 18-39 years) and non-AYAs (aged 40-89 years). The trifecta criteria, defined as a negative surgical margin, no perioperative complications (Clavien-Dindo grade > 2), and preserved postoperative renal function (1-year postoperative estimated glomerular filtration rate > 90% of baseline), were used to compare outcomes. We performed 1:1 propensity-score matching on the patient cohort. RESULTS: There were initially 125 and 898 patients in the AYAs and non-AYAs groups, respectively, and 108 patients were included in each group after propensity score matching. There were no significant differences in surgical factors (operation time, clamping ischemia time, estimated blood loss, length of hospital stay, surgical complication rate) or renal function in the early postoperative period. The mean postoperative renal function was better (p = 0.0200) and the decrease in estimated glomerular filtration rate was lower (p = 0.0026) in AYAs than in non-AYAs 12 months postoperatively. The trifecta achievement rates in the AYAs and non-AYAs groups were significantly different (67.6% and 53.7%, respectively, p = 0.0220). CONCLUSION: Although there was no difference in surgical burden between the groups, the estimated glomerular filtration rate was better preserved in AYAs than in non-AYAs at 6 and 12 months post-RAPN.
BACKGROUND: Cancer development in adolescents and young adults (AYAs) has elicited recent interest. We investigated the surgical and functional outcomes of robot-assisted laparoscopic partial nephrectomy (RAPN) for renal cell carcinoma (RCC) in AYAs. METHODS: We retrospectively reviewed the medical records of 1023 patients with clinical stage I RCC who underwent RAPN before January 2021. Patients were divided into two groups: AYAs (aged 18-39 years) and non-AYAs (aged 40-89 years). The trifecta criteria, defined as a negative surgical margin, no perioperative complications (Clavien-Dindo grade > 2), and preserved postoperative renal function (1-year postoperative estimated glomerular filtration rate > 90% of baseline), were used to compare outcomes. We performed 1:1 propensity-score matching on the patient cohort. RESULTS: There were initially 125 and 898 patients in the AYAs and non-AYAs groups, respectively, and 108 patients were included in each group after propensity score matching. There were no significant differences in surgical factors (operation time, clamping ischemia time, estimated blood loss, length of hospital stay, surgical complication rate) or renal function in the early postoperative period. The mean postoperative renal function was better (p = 0.0200) and the decrease in estimated glomerular filtration rate was lower (p = 0.0026) in AYAs than in non-AYAs 12 months postoperatively. The trifecta achievement rates in the AYAs and non-AYAs groups were significantly different (67.6% and 53.7%, respectively, p = 0.0220). CONCLUSION: Although there was no difference in surgical burden between the groups, the estimated glomerular filtration rate was better preserved in AYAs than in non-AYAs at 6 and 12 months post-RAPN.
Authors: Pierre A Clavien; Jeffrey Barkun; Michelle L de Oliveira; Jean Nicolas Vauthey; Daniel Dindo; Richard D Schulick; Eduardo de Santibañes; Juan Pekolj; Ksenija Slankamenac; Claudio Bassi; Rolf Graf; René Vonlanthen; Robert Padbury; John L Cameron; Masatoshi Makuuchi Journal: Ann Surg Date: 2009-08 Impact factor: 12.969
Authors: Steven C Campbell; Andrew C Novick; Arie Belldegrun; Michael L Blute; George K Chow; Ithaar H Derweesh; Martha M Faraday; Jihad H Kaouk; Raymond J Leveillee; Surena F Matin; Paul Russo; Robert G Uzzo Journal: J Urol Date: 2009-08-14 Impact factor: 7.450
Authors: Allison G Close; Alexandra Dreyzin; Kimberly D Miller; Brittani K N Seynnaeve; Louis B Rapkin Journal: CA Cancer J Clin Date: 2019-10-08 Impact factor: 508.702
Authors: Archie Bleyer; Ronald Barr; Brandon Hayes-Lattin; David Thomas; Chad Ellis; Barry Anderson Journal: Nat Rev Cancer Date: 2008-04 Impact factor: 60.716
Authors: James V Tricoli; Lisa A Boardman; Rajesh Patidar; Sivasish Sindiri; Jin S Jang; William D Walsh; Paul M McGregor; Corinne E Camalier; Michele G Mehaffey; Wayne L Furman; Armita Bahrami; P Mickey Williams; Chih-Jian Lih; Barbara A Conley; Javed Khan Journal: Cancer Date: 2017-11-30 Impact factor: 6.860
Authors: Ashley Wilder Smith; Nita L Seibel; Denise R Lewis; Karen H Albritton; Donald F Blair; Charles D Blanke; W Archie Bleyer; David R Freyer; Ann M Geiger; Brandon Hayes-Lattin; James V Tricoli; Lynne I Wagner; Bradley J Zebrack Journal: Cancer Date: 2016-02-05 Impact factor: 6.860