Systematic Review of Perioperative and Quality-of-life Outcomes Following Surgical Management of Localised Renal Cancer

MacLennan, Steven; Imamura, Mari; Lapitan, Marie Carmela; Omar, Muhammad Imran; Lam, Thomas; Hilvano-Cabungcal, Ana M.; Royle, Pamela; Stewart, Fiona; MacLennan, Graeme; MacLennan, Sara; Dahm, Philipp; Canfield, Steven E.; McClinton, Samuel; Griffiths, T.R. Leyshon; Ljungberg, Börje; N’Dow, James

doi:10.1016/j.eururo.2012.07.028

Cited by 235 publications

(165 citation statements)

References 52 publications

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“…According to oncological and quality-of-life outcomes, localised T1a-b tumours are best managed by partial nephrectomy (PN) rather than radical nephrectomy (RN), if technically feasible, irrespective of the surgical approach (LE 1b; [50,51]. On the basis of these data, laparoscopic RN has lower morbidity compared to open surgery (LE 1b).…”

Section: Surgical Treatmentmentioning

confidence: 99%

“…Table 1) [7]. These reviews included all relevant published literature comparing surgical management of localised RCC (T1-2N0M0) [50,51], different strategies for small RMs, lymphadenectomy and adrenalectomy [6], caval venous thrombus, and local therapy of metastases from RCC. Owing to the very limited number of RCTs, nonrandomised studies (NRSs), prospective observational studies with controls, retrospective matched-pair studies, and comparative studies from the databases of well-defined registries were also included.…”

Section: Other Renal Tumoursmentioning

confidence: 99%

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EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Ljungberg¹,

Bensalah²,

Canfield³

et al. 2015

European Urology

2,677

1,914

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Context: The European Association of Urology Guideline Panel for Renal Cell Carcinoma (RCC) has prepared evidence-based guidelines and recommendations for RCC management. Objectives: To provide an update of the 2010 RCC guideline based on a standardised methodology that is robust, transparent, reproducible, and reliable. Evidence acquisition: For the 2014 update, the panel prioritised the following topics: percutaneous biopsy of renal masses, treatment of localised RCC (including surgical and nonsurgical management), lymph node dissection, management of venous thrombus, systemic therapy, and local treatment of metastases, for which evidence synthesis was undertaken based on systematic reviews adhering to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Relevant databases (Medline, Cochrane Library, trial registries, conference proceedings) were searched (January 2000 to November 2013) including randomised controlled trials (RCTs) and retrospective or controlled studies with a comparator arm. Risk of bias (RoB) assessment and qualitative and quantitative synthesis of the evidence were performed. The remaining sections of the document were updated following a structured literature assessment. Evidence synthesis: All chapters of the RCC guideline were updated. For the various systematic reviews, the search identified a total of 10 862 articles. A total of 151 studies reporting on 78 792 patients were eligible for inclusion; where applicable, data from RCTs were included and meta-analyses were performed. For RCTs, there was low RoB across studies; however, clinical and methodological heterogeneity prevented data pooling for most studies. The majority of studies included were retrospective with matched or unmatched cohorts based on single or multi-institutional data or national registries. The exception was for systemic treatment of metastatic RCC, in which several RCTs have been performed, resulting in recommendations based on higher levels of evidence.

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Section: Surgical Treatmentmentioning

confidence: 99%

Section: Other Renal Tumoursmentioning

confidence: 99%

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Ljungberg¹,

Bensalah²,

Canfield³

et al. 2015

European Urology

2,677

1,914

View full text Add to dashboard Cite

show abstract

“…Open NSS has become a well-accepted surgical procedure for localized RCC because of its equivalent recurrence-free survival to that of RN and its good preservation of renal function [18] . A decreased deterioration of renal function due to the surgical procedure of NSS may contribute to decreased morbidity of noncancer diseases such as cardiovascular disease [3,19] .…”

Section: Discussionmentioning

confidence: 99%

Renoprotective Procedures with a Cold Ischemia Time of <60 min Minimize the Deterioration of Kidney Function in Open Nephron-Sparing Surgery for Renal Cell Carcinoma

Nishida

Yamagishi²,

Yagi³

et al. 2017

Urol Int

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Introduction: We evaluated whether nephron sparing surgery (NSS) combined with meticulous suturing of the cut stump under clamping with cooling is beneficial for oncological outcomes and also assessed the relationship between cold ischemia time and deterioration of renal function. Methods: One hundred and six patients with renal cell carcinoma (RCC) were subjected to this procedure. Oncological outcomes and renal function according to the estimated glomerular filtration rate (eGFR) and the tubular excretion rate on renoscintigraphy before and at 12 months after surgery were evaluated. Results: Cancer recurrences were observed in 2 patients with past history of RCC; however, no patient died of cancer. Renal function was evaluated depending on 4 different ischemia times. All groups did not show a remarkable decrease of renal function in terms of eGFR. Renoscintigraphy revealed the deterioration of the affected kidney in patients with >60 min ischemia. Conclusion: The renoprotective procedure of NSS provided maximum preservation of renal function until 60 min of cold ischemia time.

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“…3,4 With the increased use of LPN, sparing renal function following LPN has become the most critical issue, in addition to the oncological outcome. 5,6 Renal functional loss (RFL) following LPN has been well-evaluated and several reports have attempted to predict RFL following LPN on the basis of preoperative information. Some anatomical classification systems, such as the Centrality index (C index), 7 Preoperative Aspects and Dimensions Used for an Anatomical (PADUA) classification system, 8 and R.E.N.A.L.…”

Section: Introductionmentioning

confidence: 99%

Modified C index: Novel predictor of postoperative renal functional loss of laparoscopic partial nephrectomy

Ito

Makiyama

Kawahara

et al. 2017

CUAJ

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Introduction: We aimed to develop a scoring system to quantify the distance between the renal hilum and renal tumour, termed the modified C index (m-CI), and to predict renal functional loss (RFL) following laparoscopic partial nephrectomy (LPN). Methods: The m-CI was measured by using computed tomography in 113 patients who underwent LPN between May 2003 and June 2014. The RFL following LPN was calculated by examining the estimated glomerular filtration rate (eGFR) and radioisotope renography one year postoperatively. The Pythagorean theorem was used to calculate the distance from the tumour centre to the renal hilum. The distance was divided by the tumour radius to obtain the m-CI. The correlation between the m-CI and the postoperative RFL were evaluated using Pearson's coefficient values. Multivariate logistic regression models were used to assess the potential predictive factors of RFL following LPN. The correlation between the m-CI and the operative time, ischemia time, and blood loss during LPN were also evaluated by the unpaired t-test. Results: Pearson's coefficient values between the postoperative RFL and the m-CI and C index were 0.294 and 0.173, respectively. In the multivariate analysis, the resected volume (p=0.031) and m-CI (p=0.036) significantly correlated with the postoperative RFL following LPN. The operative time (p<0.001), ischemia time (p=0.028), and blood loss (p=0.047) during LPN was significantly longer and larger, respectively, in the group with shorter m-CI (≤4.5) than in the group with the longer m-CI (>4.5). Conclusions:The present study demonstrates that the m-CI can predict RFL following LPN, as well as the surgical difficulty.

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Systematic Review of Perioperative and Quality-of-life Outcomes Following Surgical Management of Localised Renal Cancer

Cited by 235 publications

References 52 publications

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

EAU Guidelines on Renal Cell Carcinoma: 2014 Update

Renoprotective Procedures with a Cold Ischemia Time of <60 min Minimize the Deterioration of Kidney Function in Open Nephron-Sparing Surgery for Renal Cell Carcinoma

Modified C index: Novel predictor of postoperative renal functional loss of laparoscopic partial nephrectomy

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