Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175)
Robot-assisted partial nephrectomy has a higher risk of postoperative medical complications and longer warm ischaemia time for hilar tumours in comparison to nonhilar tumours. Rates of transfusion and high-grade complications and functional and oncological outcomes were comparable between the groups...
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| Veröffentlicht in: | European urology oncology 2024-12, Vol.7 (6), p.1487-1496 |
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| creator | Sarkis, Julien Champy, Cecile M. Doumerc, Nicolas Bruyere, Franck Rouprêt, Morgan Branger, Nicolas Surlemont, Louis Michel, Constance Waeckel, Thibaut Parier, Bastien Beauval, Jean-Baptiste Bigot, Pierre Lang, Hervé Vallee, Maxime Guillotreau, Julien Patard, Jean-Jacques Sarrazin, Clément de Vergie, Stéphane Belas, Olivier Boissier, Romain Mallet, Richard Panthier, Frédéric Taha, Fayek Le Clerc, Quentin-Côme Hoquetis, Lionel Audenet, François Vignot, Louis Paparel, Philippe Fontenil, Alexis Bernhard, Jean-Christophe Ingels, Alexandre |
| description | Robot-assisted partial nephrectomy has a higher risk of postoperative medical complications and longer warm ischaemia time for hilar tumours in comparison to nonhilar tumours. Rates of transfusion and high-grade complications and functional and oncological outcomes were comparable between the groups.
A hilar location for a renal tumour is sometimes viewed as a limiting factor for safe partial nephrectomy. Our aim was to evaluate perioperative, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) for hilar tumours (RAPN-H) in comparison to RAPN for nonhilar tumours (RAPN-NH).
We conducted an observational, multicentre cohort study using prospectively collected data from the French Research Network on Kidney Cancer (UroCCR). The registry includes data for 3551 patients who underwent RAPN for localised or locally advanced renal masses between 2010 and 2023 in 29 hospitals in France. We studied the impact of a hilar location on surgery, postoperative renal function, tumour characteristics, and survival. We also compared rates of trifecta achievement (warm ischaemia time [WIT] |
| doi_str_mv | 10.1016/j.euo.2024.06.003 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_3073230710</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S2588931124001500</els_id><sourcerecordid>3073230710</sourcerecordid><originalsourceid>FETCH-LOGICAL-c1507-e8998266203772170eabf77dd15b7ae15deadb2f5dfdd28393752d1f6fc9d2e63</originalsourceid><addsrcrecordid>eNp9kcFO3DAQhqOqqCDKA_RS-UilTWo7TZy0JxQBiwTLKi1ny7EnXa8SO7UdpH3CvhZeliJOvdhj6Z9PM_6S5BPBGcGk_LrNYLYZxfRbhssM4_xdckKLqkrrnJD3b-rj5Mz7LcY4ZjHB9ENynFd1zihmJ8nf1nY2pMJ77QMotBYuaDGgFUwbBzLYcYd669BSD8IhYRRaWbN5frRgYvAutoL_jho7TsJpbw2yPVqD03YCJ4J-hAW6N9IO9reWYlg8Q65mI4O2e0ALfh6CR9ogge5iqSWY4ACtnfVTHCESIn1jXUDnq8t1e7FEP8Osdgv04GzTtIiw4svH5KgXg4ezl_s0ebi6_NUs09v765vm4jaVpMAshaquK1qWFOeMUcIwiK5nTClSdEwAKRQI1dG-UL1StMrjNxVUkb7sZa0olPlpcn7gTs7-mcEHPmovYRiEATt7nmOW03gQHKPkEJVxEe-g55PTo3A7TjDfK-RbHhXyvUKOSx4Vxp7PL_i5G0G9dvwTFgM_DgGISz5qcNxLDUaC0ntdXFn9H_wT5-Ct9g</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3073230710</pqid></control><display><type>article</type><title>Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175)</title><source>MEDLINE</source><source>Alma/SFX Local Collection</source><creator>Sarkis, Julien ; Champy, Cecile M. ; Doumerc, Nicolas ; Bruyere, Franck ; Rouprêt, Morgan ; Branger, Nicolas ; Surlemont, Louis ; Michel, Constance ; Waeckel, Thibaut ; Parier, Bastien ; Beauval, Jean-Baptiste ; Bigot, Pierre ; Lang, Hervé ; Vallee, Maxime ; Guillotreau, Julien ; Patard, Jean-Jacques ; Sarrazin, Clément ; de Vergie, Stéphane ; Belas, Olivier ; Boissier, Romain ; Mallet, Richard ; Panthier, Frédéric ; Taha, Fayek ; Le Clerc, Quentin-Côme ; Hoquetis, Lionel ; Audenet, François ; Vignot, Louis ; Paparel, Philippe ; Fontenil, Alexis ; Bernhard, Jean-Christophe ; Ingels, Alexandre</creator><creatorcontrib>Sarkis, Julien ; Champy, Cecile M. ; Doumerc, Nicolas ; Bruyere, Franck ; Rouprêt, Morgan ; Branger, Nicolas ; Surlemont, Louis ; Michel, Constance ; Waeckel, Thibaut ; Parier, Bastien ; Beauval, Jean-Baptiste ; Bigot, Pierre ; Lang, Hervé ; Vallee, Maxime ; Guillotreau, Julien ; Patard, Jean-Jacques ; Sarrazin, Clément ; de Vergie, Stéphane ; Belas, Olivier ; Boissier, Romain ; Mallet, Richard ; Panthier, Frédéric ; Taha, Fayek ; Le Clerc, Quentin-Côme ; Hoquetis, Lionel ; Audenet, François ; Vignot, Louis ; Paparel, Philippe ; Fontenil, Alexis ; Bernhard, Jean-Christophe ; Ingels, Alexandre ; Comité Cancer de l’Association Française d’Urologie</creatorcontrib><description>Robot-assisted partial nephrectomy has a higher risk of postoperative medical complications and longer warm ischaemia time for hilar tumours in comparison to nonhilar tumours. Rates of transfusion and high-grade complications and functional and oncological outcomes were comparable between the groups.
A hilar location for a renal tumour is sometimes viewed as a limiting factor for safe partial nephrectomy. Our aim was to evaluate perioperative, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) for hilar tumours (RAPN-H) in comparison to RAPN for nonhilar tumours (RAPN-NH).
We conducted an observational, multicentre cohort study using prospectively collected data from the French Research Network on Kidney Cancer (UroCCR). The registry includes data for 3551 patients who underwent RAPN for localised or locally advanced renal masses between 2010 and 2023 in 29 hospitals in France. We studied the impact of a hilar location on surgery, postoperative renal function, tumour characteristics, and survival. We also compared rates of trifecta achievement (warm ischaemia time [WIT] <25 min, negative surgical margins, and no perioperative complications) between the groups. Finally, we performed a subgroup analysis of RAPN without vascular clamping. Variables were compared in univariable analysis and using multivariable linear, logistic, and Cox proportional-hazards models adjusted for relevant patient and tumour covariates.
The analytical population included 3451 patients, of whom 2773 underwent RAPN-NH and 678 underwent RAPN-H. Longer WIT (β = 2.4 min; p < 0.01), longer operative time (β = 11.4 min; p < 0.01) and a higher risk of postoperative complications (odds ratio 1.33; p = 0.05) were observed in the hilar group. Blood loss, the perioperative transfusion rate, postoperative changes in the estimated glomerular filtration rate, and trifecta achievement rates were comparable between the groups (p > 0.05). At mean follow-up of 31.9 mo, there was no significant difference in recurrence-free survival (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.58–1.2; p = 0.3), cancer-specific survival (HR 1.1, 95% CI 0.48–2.6; p = 0.79), or overall survival (HR 0.89, 95% CI 0.52–1.53; p = 0.69).
Patient and tumour characteristics rather than just hilar location should be the main determinants of the optimal surgical strategy for hilar tumours.
We found that kidney tumours located close to major kidney blood vessels led to a longer operation and a higher risk of complications during robot-assisted surgery to remove the tumour. However, tumours in these locations were not related to a higher risk of kidney function loss, cancer recurrence, or death.</description><identifier>ISSN: 2588-9311</identifier><identifier>EISSN: 2588-9311</identifier><identifier>DOI: 10.1016/j.euo.2024.06.003</identifier><identifier>PMID: 38937207</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Aged ; Cohort Studies ; Female ; France - epidemiology ; Hilar tumours ; Humans ; Kidney cancer ; Kidney Neoplasms - pathology ; Kidney Neoplasms - surgery ; Male ; Middle Aged ; Nephrectomy - methods ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Prospective Studies ; Renal cell carcinoma ; Robot-assisted partial nephrectomy ; Robotic Surgical Procedures - methods ; Treatment Outcome</subject><ispartof>European urology oncology, 2024-12, Vol.7 (6), p.1487-1496</ispartof><rights>2024 European Association of Urology</rights><rights>Copyright © 2024 European Association of Urology. Published by Elsevier B.V. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c1507-e8998266203772170eabf77dd15b7ae15deadb2f5dfdd28393752d1f6fc9d2e63</cites><orcidid>0000-0002-5060-0819</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38937207$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Sarkis, Julien</creatorcontrib><creatorcontrib>Champy, Cecile M.</creatorcontrib><creatorcontrib>Doumerc, Nicolas</creatorcontrib><creatorcontrib>Bruyere, Franck</creatorcontrib><creatorcontrib>Rouprêt, Morgan</creatorcontrib><creatorcontrib>Branger, Nicolas</creatorcontrib><creatorcontrib>Surlemont, Louis</creatorcontrib><creatorcontrib>Michel, Constance</creatorcontrib><creatorcontrib>Waeckel, Thibaut</creatorcontrib><creatorcontrib>Parier, Bastien</creatorcontrib><creatorcontrib>Beauval, Jean-Baptiste</creatorcontrib><creatorcontrib>Bigot, Pierre</creatorcontrib><creatorcontrib>Lang, Hervé</creatorcontrib><creatorcontrib>Vallee, Maxime</creatorcontrib><creatorcontrib>Guillotreau, Julien</creatorcontrib><creatorcontrib>Patard, Jean-Jacques</creatorcontrib><creatorcontrib>Sarrazin, Clément</creatorcontrib><creatorcontrib>de Vergie, Stéphane</creatorcontrib><creatorcontrib>Belas, Olivier</creatorcontrib><creatorcontrib>Boissier, Romain</creatorcontrib><creatorcontrib>Mallet, Richard</creatorcontrib><creatorcontrib>Panthier, Frédéric</creatorcontrib><creatorcontrib>Taha, Fayek</creatorcontrib><creatorcontrib>Le Clerc, Quentin-Côme</creatorcontrib><creatorcontrib>Hoquetis, Lionel</creatorcontrib><creatorcontrib>Audenet, François</creatorcontrib><creatorcontrib>Vignot, Louis</creatorcontrib><creatorcontrib>Paparel, Philippe</creatorcontrib><creatorcontrib>Fontenil, Alexis</creatorcontrib><creatorcontrib>Bernhard, Jean-Christophe</creatorcontrib><creatorcontrib>Ingels, Alexandre</creatorcontrib><creatorcontrib>Comité Cancer de l’Association Française d’Urologie</creatorcontrib><title>Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175)</title><title>European urology oncology</title><addtitle>Eur Urol Oncol</addtitle><description>Robot-assisted partial nephrectomy has a higher risk of postoperative medical complications and longer warm ischaemia time for hilar tumours in comparison to nonhilar tumours. Rates of transfusion and high-grade complications and functional and oncological outcomes were comparable between the groups.
A hilar location for a renal tumour is sometimes viewed as a limiting factor for safe partial nephrectomy. Our aim was to evaluate perioperative, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) for hilar tumours (RAPN-H) in comparison to RAPN for nonhilar tumours (RAPN-NH).
We conducted an observational, multicentre cohort study using prospectively collected data from the French Research Network on Kidney Cancer (UroCCR). The registry includes data for 3551 patients who underwent RAPN for localised or locally advanced renal masses between 2010 and 2023 in 29 hospitals in France. We studied the impact of a hilar location on surgery, postoperative renal function, tumour characteristics, and survival. We also compared rates of trifecta achievement (warm ischaemia time [WIT] <25 min, negative surgical margins, and no perioperative complications) between the groups. Finally, we performed a subgroup analysis of RAPN without vascular clamping. Variables were compared in univariable analysis and using multivariable linear, logistic, and Cox proportional-hazards models adjusted for relevant patient and tumour covariates.
The analytical population included 3451 patients, of whom 2773 underwent RAPN-NH and 678 underwent RAPN-H. Longer WIT (β = 2.4 min; p < 0.01), longer operative time (β = 11.4 min; p < 0.01) and a higher risk of postoperative complications (odds ratio 1.33; p = 0.05) were observed in the hilar group. Blood loss, the perioperative transfusion rate, postoperative changes in the estimated glomerular filtration rate, and trifecta achievement rates were comparable between the groups (p > 0.05). At mean follow-up of 31.9 mo, there was no significant difference in recurrence-free survival (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.58–1.2; p = 0.3), cancer-specific survival (HR 1.1, 95% CI 0.48–2.6; p = 0.79), or overall survival (HR 0.89, 95% CI 0.52–1.53; p = 0.69).
Patient and tumour characteristics rather than just hilar location should be the main determinants of the optimal surgical strategy for hilar tumours.
We found that kidney tumours located close to major kidney blood vessels led to a longer operation and a higher risk of complications during robot-assisted surgery to remove the tumour. However, tumours in these locations were not related to a higher risk of kidney function loss, cancer recurrence, or death.</description><subject>Aged</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>France - epidemiology</subject><subject>Hilar tumours</subject><subject>Humans</subject><subject>Kidney cancer</subject><subject>Kidney Neoplasms - pathology</subject><subject>Kidney Neoplasms - surgery</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nephrectomy - methods</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Prospective Studies</subject><subject>Renal cell carcinoma</subject><subject>Robot-assisted partial nephrectomy</subject><subject>Robotic Surgical Procedures - methods</subject><subject>Treatment Outcome</subject><issn>2588-9311</issn><issn>2588-9311</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kcFO3DAQhqOqqCDKA_RS-UilTWo7TZy0JxQBiwTLKi1ny7EnXa8SO7UdpH3CvhZeliJOvdhj6Z9PM_6S5BPBGcGk_LrNYLYZxfRbhssM4_xdckKLqkrrnJD3b-rj5Mz7LcY4ZjHB9ENynFd1zihmJ8nf1nY2pMJ77QMotBYuaDGgFUwbBzLYcYd669BSD8IhYRRaWbN5frRgYvAutoL_jho7TsJpbw2yPVqD03YCJ4J-hAW6N9IO9reWYlg8Q65mI4O2e0ALfh6CR9ogge5iqSWY4ACtnfVTHCESIn1jXUDnq8t1e7FEP8Osdgv04GzTtIiw4svH5KgXg4ezl_s0ebi6_NUs09v765vm4jaVpMAshaquK1qWFOeMUcIwiK5nTClSdEwAKRQI1dG-UL1StMrjNxVUkb7sZa0olPlpcn7gTs7-mcEHPmovYRiEATt7nmOW03gQHKPkEJVxEe-g55PTo3A7TjDfK-RbHhXyvUKOSx4Vxp7PL_i5G0G9dvwTFgM_DgGISz5qcNxLDUaC0ntdXFn9H_wT5-Ct9g</recordid><startdate>202412</startdate><enddate>202412</enddate><creator>Sarkis, Julien</creator><creator>Champy, Cecile M.</creator><creator>Doumerc, Nicolas</creator><creator>Bruyere, Franck</creator><creator>Rouprêt, Morgan</creator><creator>Branger, Nicolas</creator><creator>Surlemont, Louis</creator><creator>Michel, Constance</creator><creator>Waeckel, Thibaut</creator><creator>Parier, Bastien</creator><creator>Beauval, Jean-Baptiste</creator><creator>Bigot, Pierre</creator><creator>Lang, Hervé</creator><creator>Vallee, Maxime</creator><creator>Guillotreau, Julien</creator><creator>Patard, Jean-Jacques</creator><creator>Sarrazin, Clément</creator><creator>de Vergie, Stéphane</creator><creator>Belas, Olivier</creator><creator>Boissier, Romain</creator><creator>Mallet, Richard</creator><creator>Panthier, Frédéric</creator><creator>Taha, Fayek</creator><creator>Le Clerc, Quentin-Côme</creator><creator>Hoquetis, Lionel</creator><creator>Audenet, François</creator><creator>Vignot, Louis</creator><creator>Paparel, Philippe</creator><creator>Fontenil, Alexis</creator><creator>Bernhard, Jean-Christophe</creator><creator>Ingels, Alexandre</creator><general>Elsevier B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5060-0819</orcidid></search><sort><creationdate>202412</creationdate><title>Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175)</title><author>Sarkis, Julien ; Champy, Cecile M. ; Doumerc, Nicolas ; Bruyere, Franck ; Rouprêt, Morgan ; Branger, Nicolas ; Surlemont, Louis ; Michel, Constance ; Waeckel, Thibaut ; Parier, Bastien ; Beauval, Jean-Baptiste ; Bigot, Pierre ; Lang, Hervé ; Vallee, Maxime ; Guillotreau, Julien ; Patard, Jean-Jacques ; Sarrazin, Clément ; de Vergie, Stéphane ; Belas, Olivier ; Boissier, Romain ; Mallet, Richard ; Panthier, Frédéric ; Taha, Fayek ; Le Clerc, Quentin-Côme ; Hoquetis, Lionel ; Audenet, François ; Vignot, Louis ; Paparel, Philippe ; Fontenil, Alexis ; Bernhard, Jean-Christophe ; Ingels, Alexandre</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c1507-e8998266203772170eabf77dd15b7ae15deadb2f5dfdd28393752d1f6fc9d2e63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Aged</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>France - 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Academic</collection><jtitle>European urology oncology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Sarkis, Julien</au><au>Champy, Cecile M.</au><au>Doumerc, Nicolas</au><au>Bruyere, Franck</au><au>Rouprêt, Morgan</au><au>Branger, Nicolas</au><au>Surlemont, Louis</au><au>Michel, Constance</au><au>Waeckel, Thibaut</au><au>Parier, Bastien</au><au>Beauval, Jean-Baptiste</au><au>Bigot, Pierre</au><au>Lang, Hervé</au><au>Vallee, Maxime</au><au>Guillotreau, Julien</au><au>Patard, Jean-Jacques</au><au>Sarrazin, Clément</au><au>de Vergie, Stéphane</au><au>Belas, Olivier</au><au>Boissier, Romain</au><au>Mallet, Richard</au><au>Panthier, Frédéric</au><au>Taha, Fayek</au><au>Le Clerc, Quentin-Côme</au><au>Hoquetis, Lionel</au><au>Audenet, François</au><au>Vignot, Louis</au><au>Paparel, Philippe</au><au>Fontenil, Alexis</au><au>Bernhard, Jean-Christophe</au><au>Ingels, Alexandre</au><aucorp>Comité Cancer de l’Association Française d’Urologie</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175)</atitle><jtitle>European urology oncology</jtitle><addtitle>Eur Urol Oncol</addtitle><date>2024-12</date><risdate>2024</risdate><volume>7</volume><issue>6</issue><spage>1487</spage><epage>1496</epage><pages>1487-1496</pages><issn>2588-9311</issn><eissn>2588-9311</eissn><abstract>Robot-assisted partial nephrectomy has a higher risk of postoperative medical complications and longer warm ischaemia time for hilar tumours in comparison to nonhilar tumours. Rates of transfusion and high-grade complications and functional and oncological outcomes were comparable between the groups.
A hilar location for a renal tumour is sometimes viewed as a limiting factor for safe partial nephrectomy. Our aim was to evaluate perioperative, oncological, and functional outcomes of robot-assisted partial nephrectomy (RAPN) for hilar tumours (RAPN-H) in comparison to RAPN for nonhilar tumours (RAPN-NH).
We conducted an observational, multicentre cohort study using prospectively collected data from the French Research Network on Kidney Cancer (UroCCR). The registry includes data for 3551 patients who underwent RAPN for localised or locally advanced renal masses between 2010 and 2023 in 29 hospitals in France. We studied the impact of a hilar location on surgery, postoperative renal function, tumour characteristics, and survival. We also compared rates of trifecta achievement (warm ischaemia time [WIT] <25 min, negative surgical margins, and no perioperative complications) between the groups. Finally, we performed a subgroup analysis of RAPN without vascular clamping. Variables were compared in univariable analysis and using multivariable linear, logistic, and Cox proportional-hazards models adjusted for relevant patient and tumour covariates.
The analytical population included 3451 patients, of whom 2773 underwent RAPN-NH and 678 underwent RAPN-H. Longer WIT (β = 2.4 min; p < 0.01), longer operative time (β = 11.4 min; p < 0.01) and a higher risk of postoperative complications (odds ratio 1.33; p = 0.05) were observed in the hilar group. Blood loss, the perioperative transfusion rate, postoperative changes in the estimated glomerular filtration rate, and trifecta achievement rates were comparable between the groups (p > 0.05). At mean follow-up of 31.9 mo, there was no significant difference in recurrence-free survival (hazard ratio [HR] 0.82, 95% confidence interval [CI] 0.58–1.2; p = 0.3), cancer-specific survival (HR 1.1, 95% CI 0.48–2.6; p = 0.79), or overall survival (HR 0.89, 95% CI 0.52–1.53; p = 0.69).
Patient and tumour characteristics rather than just hilar location should be the main determinants of the optimal surgical strategy for hilar tumours.
We found that kidney tumours located close to major kidney blood vessels led to a longer operation and a higher risk of complications during robot-assisted surgery to remove the tumour. However, tumours in these locations were not related to a higher risk of kidney function loss, cancer recurrence, or death.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>38937207</pmid><doi>10.1016/j.euo.2024.06.003</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-5060-0819</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2588-9311 |
| ispartof | European urology oncology, 2024-12, Vol.7 (6), p.1487-1496 |
| issn | 2588-9311 2588-9311 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_3073230710 |
| source | MEDLINE; Alma/SFX Local Collection |
| subjects | Aged Cohort Studies Female France - epidemiology Hilar tumours Humans Kidney cancer Kidney Neoplasms - pathology Kidney Neoplasms - surgery Male Middle Aged Nephrectomy - methods Postoperative Complications - epidemiology Postoperative Complications - etiology Prospective Studies Renal cell carcinoma Robot-assisted partial nephrectomy Robotic Surgical Procedures - methods Treatment Outcome |
| title | Robot-assisted Partial Nephrectomy for Hilar and Nonhilar Renal Masses: Comparison of Perioperative, Oncological, and Functional Results in a Multicentre Prospective Cohort (NEPRAH Study, UroCCR 175) |
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