Clinical and oncological outcomes of open partial nephrectomy versus robot assisted partial nephrectomy over 15 years

Audigé, Victor; Baghli, Adnan; Hubert, Jacques; Mazeaud, Charles; Larré, S.; Branchu, Benjamin

doi:10.1007/s11701-022-01446-1

Cited by 8 publications

(3 citation statements)

References 40 publications

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“…After fulfilling all the inclusion criteria, 13 studies were identified [ 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ], and another 17 studies were excluded mainly because follow-up was too short [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 ]. All of the studies had an retrospective design except the ones from Furukawa et al [ 16 ] and Beauval et al [ 24 ].…”

Section: Resultsmentioning

confidence: 99%

“…A head-to-head prospective comparison had, until now, not been performed, and is unlikely to ever be performed. Recently Audigé et al showed, in a retrospective analysis, that CFS and OS did not differ at seven years of follow-up; however a greater amount of local recurrences were reported in the OPN cohort [ 15 ]. Other comparison studies with minimum four years of follow-up reported slightly better CFS, CSS or OS in favor of RAPN over OPN [ 22 , 23 , 25 ]; however, lack of standardized reporting of results, heterogeneity of the studies, and patient selection may have influenced the results.…”

Section: Discussionmentioning

confidence: 99%

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Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Vartolomei

Remzi

Fajković

et al. 2022

JCM

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Background: Robot-assisted partial nephrectomy (RAPN) is used more and more in present days as a therapy option for surgical treatment of cT1 renal masses. Current guidelines equally recommend open (OPN), laparoscopic (LPN), or robotic partial nephrectomy (PN). The aim of this review was to analyze the most representative RAPN series in terms of reported oncological outcomes. (2) Methods: A systematic search of Webofscience, PUBMED, Clinicaltrials.gov was performed on 1 August 2022. Studies were considered eligible if they: included patients with renal cell carcinoma (RCC) stage T1, were prospective, used randomized clinical trials (RCT) or retrospective studies, had patients undergo RAPN with a minimum follow-up of 48 months. (3) Results: Reported positive surgical margin rates were from 0 to 10.5%. Local recurrence occurred in up to 3.6% of patients. Distant metastases were reported in up to 6.4% of patients. 5-year cancer free survival (CFS) estimates rates ranged from 86.4% to 98.4%. 5-year cancer specific survival (CSS) estimates rates ranged from 90.1% to 100%, and 5-year overall survival (OS) estimates rated ranged from 82.6% to 97.9%. (4) Conclusions: Data coming from retrospective and prospective series shows very good oncologic outcomes after RAPN. Up to now, 10-year survival outcomes were not reported. Taken together, RAPN deliver similar oncologic performance to OPN and LPN.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Vartolomei

Remzi

Fajković

et al. 2022

JCM

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“…PN can be performed through laparoscopic, robotic, or open approaches [15][16][17]. European guidelines pointed out that the choice of the approach is secondary, emphasizing the importance of performing nephron-sparing surgery (NSS) whenever technically feasible, regardless of the type of surgical approach [7].…”

Section: Introductionmentioning

confidence: 99%

Comparison of Perioperative, Functional, and Oncologic Outcomes of Open vs. Robot-Assisted Off-Clamp Partial Nephrectomy: A Propensity Scored Match Analysis

Mastroianni,

Chiacchio,

Perpepaj

et al. 2024

Sensors

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Off-clamp partial nephrectomy represents one of the latest developments in nephron-sparing surgery, with the goal of preserving renal function and reducing ischemia time. The aim of this study was to evaluate and compare the functional, oncologic, and perioperative outcomes between off-clamp robot-assisted partial nephrectomy (off-C RAPN) and off-clamp open partial nephrectomy (off-C OPN) through a propensity score-matched (PSM) analysis. A 1:1 PSM analysis was used to balance variables potentially affecting postoperative outcomes. To report surgical quality, 1 year trifecta was used. Univariable Cox regression analysis was performed to identify predictors of trifecta achievement. The Kaplan–Meier method was used to compare cancer-specific survival (CSS), overall survival (OS), disease-free survival (DFS), and metastasis-free survival (MFS) probabilities between groups. Overall, 542 patients were included. After PSM analysis, two homogeneous cohorts of 147 patients were obtained. The off-C RAPN cohort experienced shorter length of stay (LoS) (3.4 days vs. 5.4 days; p < 0.001), increased likelihoods of achieving 1 year trifecta (89.8% vs. 80.3%; p = 0.03), lower postoperative Clavien–Dindo ≤ 2 complications (1.3% vs. 18.3%, p < 0.001), and lower postoperative transfusion rates (3.4% vs. 12.2%, p = 0.008). At univariable analysis, the surgical approach (off-C RAPN vs. off-C OPN, OR 2.22, 95% CI 1.09–4.46, p = 0.02) was the only predictor of 1 year trifecta achievement. At Kaplan–Meier analysis, no differences were observed between the two groups in terms of OS (log-rank p = 0.451), CSS (log-rank p = 0.476), DFS (log-rank p = 0.678), and MFS (log-rank p = 0.226). Comparing RAPN and OPN in a purely off-clamp scenario, the minimally invasive approach proved to be a feasible and safe surgical approach, with a significantly lower LoS and minor rate of postoperative complications and transfusions as a result of improved surgical quality expressed by higher 1 year trifecta achievement.

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Cost-effectiveness of robotic-assisted surgery vs open surgery in the context of partial nephrectomy for small kidney tumors

et al. 2023

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Clinical and oncological outcomes of open partial nephrectomy versus robot assisted partial nephrectomy over 15 years

Cited by 8 publications

References 40 publications

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Robot-Assisted Partial Nephrectomy Mid-Term Oncologic Outcomes: A Systematic Review

Comparison of Perioperative, Functional, and Oncologic Outcomes of Open vs. Robot-Assisted Off-Clamp Partial Nephrectomy: A Propensity Scored Match Analysis

Cost-effectiveness of robotic-assisted surgery vs open surgery in the context of partial nephrectomy for small kidney tumors

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