Limited data are available concerning the outcome of robot-assisted partial nephrectomy (RAPN) in cystic tumors. To evaluate outcomes of RAPN in cystic tumors, analyzing a large, multi-institutional, retrospective series of RAPN.
We evaluated 465 patients who received RAPN for either cystic or solid tumors from 2010 to 2013 and included in the multi-institutional, retrospective GQI-RUS database. Univariable and multivariable linear and logistic regression models addressed the association of cystic tumors with perioperative outcomes.
Fifty-four (12%) tumors were cystic. Cystic tumors were associated with significantly lower operative time (t -3.9; p <0.001), once adjusted for the effect of covariates, whereas blood loss and ischemia time were similar. Postoperative any grade complications were recorded in 66 non-cystic (16%) and 9 cystic (17%) tumors (p = 0.08). In multivariable analysis, cystic tumors were not associated with a significantly lower risk of any grade postoperative complications (OR [odds ratio] 0.9; p = 0.8). Similarly, presence of tumors with cystic features was not associated with a significantly different risk of high grade postoperative complications (OR 2.2; p = 0.1). Prevalence of cancer histology and positive surgical margin rates were similar in cystic and non-cystic tumors. Cystic tumors were not associated with significantly different postoperative estimated glomerular filtration rate (t 0.4; p = 0.7), once adjusted for the effect of covariates.
RAPN can be performed in cystic renal tumor with perioperative, pathological, and functional outcomes similar to those achievable in solid tumors. This article is protected by copyright All rights reserved.
BJU international 2015 Aug 25 [Epub ahead of print]
Giacomo Novara, Sabrina La Falce, Ronney Abaza, James Adshead, Rajesh Ahlawat, Nicolò Maria Buffi, Ben Challacombe, Prokar Dasgupta, Daniel A Moon, Dipen Parekh, Francesco Porpiglia, Sudhir Rawal, Craig Rogers, Alessandro Volpe, Mahendra Bhandari, Alexander Mottrie
Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy , Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padua, Padua, Italy , Department of Urology, Ohio Health Dublin Methodist Hospital, Dublin, Ohio, USA , Hertfordshire and South Bedfordshire Urological Cancer Centre, Lister Hospital, Stevenage, UK , Division of Urology and Renal Transplantation, Medanta Kidney and Urology Institute, Medanta, the Medicity, Gurgaon, India , Humanitas Clinical and Research Center, Rozzano, MI, Italy , MRC Centre for Transplantation, King's College London, London, UK , MRC Centre for Transplantation, King's College London, London, UK , Peter MacCallum Cancer Centre, Melbourne, Australia , University of Miami Miller School of Medicine and Sylvestor Comprehensive Cancer Center, Miami, FL, USA , San Luigi Gonzaga Hospital, University of Turin, Orbassano, Italy , Rajiv Gandhi Cancer Hospital, New Delhi, India , Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA , University of Eastern Piedmont, Novara, Italy , Vattikuti Urology Institute, Henry Ford Hospital, Detroit, MI, USA , Department of Urology, Onze-Lieve-Vrouw Hospital, Aalst, Belgium