TY - JOUR
T1 - Robotic Partial Nephrectomy versus Minimally Invasive Radical Nephrectomy for Clinical T2a Renal Mass: A Propensity Score Matched Comparison from the ROSULA (Robotic Surgery for Large Renal Mass) Collaborative Group.
AU - Bradshaw, Aaron W
AU - Autorino, Riccardo
AU - Simone, Giuseppe
AU - Yang, Bo
AU - Uzzo, Robert G
AU - Porpiglia, Francesco
AU - Capitanio, Umberto
AU - Porter, James R
AU - Bertolo, Riccardo
AU - Minervini, Andrea
AU - Lau, Clayton
AU - Jacobsohn, Kenneth
AU - Ashrafi, Akbar
AU - Eun, Daniel
AU - Mottrie, Alexander
AU - White, Wesley M
AU - Schips, Luigi
AU - Challacombe, Benjamin J
AU - Cobelli, Ottavio De
AU - Mir, Carmen M
AU - Veccia, Alessandro
AU - Larcher, Alessandro
AU - Kutikov, Alexander
AU - Aron, Monish
AU - Dasgupta, Prokar
AU - Montorsi, Francesco
AU - Gill, Inderbir S
AU - Sundaram, Chandru P
AU - Kaouk, Jihad
AU - Derweesh, Ithaar H
PY - 2020/3/31
Y1 - 2020/3/31
N2 - OBJECTIVE: To compare outcomes of minimally invasive radical nephrectomy (MIS-RN) and robotic-assisted partial nephrectomy (RAPN) in clinical T2a renal mass (T2aRM).
METHODS: Retrospective, multicenter, propensity score-matched (PSM) comparison of RAPN and MIS-RN for T2aRM (T2aN0M0). Cohorts were PSM for age, sex, BMI, ASA Class, clinical tumor size, and RENAL score using 2:1 ratio for RN:PN. Primary outcome was disease-free survival (DFS). Secondary outcomes included overall survival (OS), complication rates, and de novo eGFR
RESULTS: 648 patients (216 RAPN/432 MIS-RN) were matched. No significant differences were noted in intraoperative complications (p=0.478), Clavien≥3 complications (p=0.063) and readmissions (p=0.238). MVA revealed high ASA score (HR 2.7, p=0.044) and sarcomatoid (HR 5.3, p=0.001), but not surgery type (p=0.601) to be associated with all-cause mortality. Increasing RENAL score (HR 1.31, p=0.037), high tumor-grade (HR 2.5, p=0.043), and sarcomatoid (HR 2.8, p=0.02) were associated with recurrence, but not surgery (p=0.555). Increasing age (HR 1.1, p
CONCLUSIONS: RAPN demonstrated similar oncologic outcomes and morbidity profile to MIS-RN while conferring functional benefit. RAPN may be considered as a first-line option for T2aRM.
AB - OBJECTIVE: To compare outcomes of minimally invasive radical nephrectomy (MIS-RN) and robotic-assisted partial nephrectomy (RAPN) in clinical T2a renal mass (T2aRM).
METHODS: Retrospective, multicenter, propensity score-matched (PSM) comparison of RAPN and MIS-RN for T2aRM (T2aN0M0). Cohorts were PSM for age, sex, BMI, ASA Class, clinical tumor size, and RENAL score using 2:1 ratio for RN:PN. Primary outcome was disease-free survival (DFS). Secondary outcomes included overall survival (OS), complication rates, and de novo eGFR
RESULTS: 648 patients (216 RAPN/432 MIS-RN) were matched. No significant differences were noted in intraoperative complications (p=0.478), Clavien≥3 complications (p=0.063) and readmissions (p=0.238). MVA revealed high ASA score (HR 2.7, p=0.044) and sarcomatoid (HR 5.3, p=0.001), but not surgery type (p=0.601) to be associated with all-cause mortality. Increasing RENAL score (HR 1.31, p=0.037), high tumor-grade (HR 2.5, p=0.043), and sarcomatoid (HR 2.8, p=0.02) were associated with recurrence, but not surgery (p=0.555). Increasing age (HR 1.1, p
CONCLUSIONS: RAPN demonstrated similar oncologic outcomes and morbidity profile to MIS-RN while conferring functional benefit. RAPN may be considered as a first-line option for T2aRM.
M3 - Article
JO - Articles, Abstracts, and Reports
JF - Articles, Abstracts, and Reports
ER -